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Heat wave
July 2004
Produced by the National Disaster Education Coalition, Washington, D. C.

(Review acknowledgment: The Environmental Protection Agency, Office of Atmospheric Programs,
Global Programs Division, Global Change Information Branch, reviewed this chapter, in addition to the agencies
listed in the acknowledgments.)


Heat (Heat Wave)

Why talk about excessive heat?


In recent years, excessive heat has caused more deaths than all other weather events, including floods. The American Meteorological
Society reports that on average heat kills more than 1,000 people each year. During the July 1995 heat wave in Chicago, more than
700 people died as a result of excessive heat.

What is a heat wave?

A heat wave is a prolonged period of excessive heat, often combined with excessive humidity. Generally, excessive heat is defined as
temperatures that hover 10 degrees or more above the average high temperature for the region during summer months, last for a
prolonged period of time, and often are accompanied by high humidity.

What is the heat index?

The heat index is the temperature the body feels when the effects of heat and humidity are combined. Exposure to direct sunlight can
increase the heat index by up to 15°F.

What are heat cramps, heat exhaustion, heatstroke, and sunstroke?

Heat cramps (see How to Recognize and Treat Heat Exhaustion and Heatstroke) are muscular pains and spasms caused by
heavy exertion in high heat. Heat cramps are often the first sign that the body is having trouble with the heat.

Heat exhaustion (see How to Recognize and Treat Heat Exhaustion and Heatstroke) typically involves the loss of body fluids
through heavy sweating when someone strenuously exercises or works in high heat and humidity. In someone suffering from heat
exhaustion, blood flow to the skin increases while blood flow to vital organs decreases, resulting in a mild form of shock. If not
treated, body temperature will continue to rise and the person may suffer heatstroke.

Heatstroke (also known as sunstroke) (see How to Recognize and Treat Heat Exhaustion and Heatstroke) is a life-threatening
condition in which a person’s temperature control system, which produces sweating to cool the body, stops working. The body
temperature of someone suffering from heatstroke can rise so high that brain damage and death may result if the body is not
cooled quickly.

Learn what heat hazards may occur where you are and how to plan for excessive heat should it occur in your area. Different
areas have different risks associated with prolonged heat. Contact your local emergency management office, National Weather Service
office, or American Red Cross chapter for information.

How can I protect myself in a heat wave?

For general preparedness, every household should create and practice a Family Disaster Plan and assemble and maintain a Disaster Supplies
Kit. In addition, households at risk from heat waves should take precautions to stay safe in case one occurs.

Review your Family Disaster Plan before summer heat is expected and be sure to stock additional water.

The best ways to be protected from the ill effects of excessive heat are to dress appropriately, stay indoors, refrain from strenuous work
or exercise during the hottest part of the day, and stay hydrated. Spending at least two hours a day in air conditioning significantly decreases
a person’s risk of heat-related illnesses.

Heat can kill by pushing the human body beyond its limits. Under normal conditions, the body's internal thermostat produces perspiration
that evaporates and cools the body. However, in excessive heat and high humidity, evaporation is slowed and the body must work extra
hard to maintain a normal temperature.

Elderly people, young children, and those who are sick or overweight are more likely to become victims of excessive heat. Because men
sweat more than women do, they become more quickly dehydrated and are more susceptible to heat illness.

The duration of excessive heat plays an important role in how people are affected by a heat wave. Studies have shown a significant rise in
heat-related illnesses when excessive heat lasts more than two days.

People living in urban areas may be at greater risk from the effects of a prolonged heat wave than are people living in rural regions. An
increased health problem, especially for those with respiratory difficulties, can occur when stagnant atmospheric conditions trap pollutants in
urban areas, thus adding unhealthy air to excessively hot temperatures. In addition, asphalt and concrete store heat longer and gradually release
heat, resulting in significantly higher temperatures, especially at night—an occurrence known as the "urban heat island effect."

Pets, horses, and livestock are also susceptible to difficulties from excessive heat. Animals do not perspire and rely on panting, wetting down,
shade, cool earth, and drinking water for cooling. Animals cannot explain their needs, so it is up to people to take extra care that during
heat waves, their needs are met.

What is the best source of information in a heat wave?

Local radio, television stations, and NOAA Weather Radio are the best sources of information in a heat wave.
NOAA Weather Radio is the prime alerting and critical information delivery system of the National Weather Service (NWS). NOAA
Weather Radio broadcasts warnings, watches, forecasts, and other hazard information 24 hours a day over more than 650 stations in the
50 states, adjacent coastal waters, Puerto Rico, the U.S. Virgin Islands, and the U.S. Pacific territories.

The NWS encourages people to buy a weather radio equipped with the Specific Area Message Encoder (SAME) feature. This feature
automatically alerts you when important excessive heat information is issued for your area. Information on NOAA Weather Radio is available
from your local NWS office or at www.nws.noaa.gov/nwr.

The National Weather Service issues alerts for excessive heat on a county-by-county basis. The alerts are broadcast on NOAA Weather Radio
and on local radio and television stations. The parameters of an excessive heat watch, warning, and advisory vary by location.

Generally:

• Excessive Heat WATCH means conditions are favorable for an event to meet or exceed local excessive heat warning criteria in the
next 12 to 48 hours. .

• Excessive Heat WARNING means that heat values are forecast to meet or exceed locally defined warning criteria for at least two days.

• Excessive Heat ADVISORY means hazardous heat conditions have begun or will begin within 36 hours and, if caution is not exercised,
they could become life threatening.

If you are at risk from excessive heat, you should:

• Discuss with members of your household the precautions they should take to stay safe in excessive heat. Everyone should know what to do
in the places where they spend time. Some places may not be air conditioned or safe during a heat wave, so plan alternatives.

• If your home does not have air conditioning, choose other places you could go to get relief from the heat during the warmest part of the day.
Schools, libraries, theaters, and other community facilities often provide air-conditioned refuge on the hottest days. See if your area designates
cooling centers. Air conditioning provides the safest escape from excessive heat. During the 1995 Midwest heat wave, most deaths happened
to people who were not in air conditioned places.

• Plan how you can change daily activities to avoid strenuous work during the Watch, Warning, Advisory

• Discuss with a physician any concerns about members of the household who are taking medications or have medical conditions that may
cause poor blood circulation or reduced ability to tolerate heat. A physician can advise you about temporary changes to medication or
other activities that can relieve the effects of heat.

• Plan to check on family, friends, and neighbors who do not have air conditioning or who spend much of their time alone. Elderly persons who
live alone or with a working relative might need assistance on hot days. The majority of people who died because of the 1995 Midwest heat
wave were persons who were alone.

• Plan to wear lightweight, light-colored clothing. Light colors will reflect away the sun's rays more than dark colors, which absorb the sun's rays.

• Get training. Take an American Red Cross first aid course to learn how to treat heat emergencies and other emergencies. Everyone should
know how to respond, because the effects of heat can happen very quickly.

• Ensure that your animals’ needs for water and shade are met. Bring companion animals into cooler areas.

What to Do During a Heat Wave

• Listen to NOAA Weather Radio or local radio or television stations for up-to-date information.

• Never leave children or pets alone in closed vehicles. Temperatures inside a closed vehicle can reach more than 140°F (60° C) within minutes.
Exposure to such high temperatures can kill in minutes. Even on days that feel pleasantly warm outside, temperatures in a closed vehicle can raise
high enough to kill children and pets.

• Slow down. Avoid strenuous activity. Reduce, eliminate, or reschedule strenuous activities. High-risk individuals should stay in cool places.
Get plenty of rest to allow your natural "cooling system" to work. If you must do strenuous activity, do it during the coolest part of the day, which
is usually in the early morning. Many heat emergencies are experienced by people exercising or working during the hottest part of the day.

• Take frequent breaks if you must work outdoors. Frequent breaks, especially in a cool area, can help people tolerate heat better.

• Use a buddy system when working in excessive heat. Partners can keep an eye on each other and can assist each other when needed.
Sometimes exposure to heat can cloud judgment, and, if you work alone, you may not notice this.

• Watch for signs of heat exhaustion and heatstroke. (See How to Recognize and Treat Heat Exhaustion and Heatstroke.)

• Avoid too much sunshine. Sunburn slows the skin's ability to cool itself. The sun will also heat the inner core of your body, resulting in
dehydration. Use a sunscreen lotion with a high sun-protection factor (SPF) rating.

• Postpone outdoor games and activities. Excessive heat can threaten the health of athletes, staff, and spectators of outdoor games and activities.

• Avoid extreme temperature changes. A cold or even a cool shower taken immediately after coming indoors from hot temperatures can result
in hypothermia, particularly for elderly and very young people.

• Stay indoors as much as possible. If air conditioning is not available, stay on the lowest floor, out of the sunshine. Even in the warmest weather,
staying indoors, out of sunshine, is safer than long periods of exposure to the sun.

• Keep heat outside and cool air inside. Close any registers that may allow heat inside. Install temporary reflectors, such as aluminum
foil-covered cardboard, in windows and skylights to reflect heat back outside.

• Conserve electricity not needed to keep you cool. During periods of excessive heat, people tend to use a lot more power for air conditioning.
Conserve electricity not used to keep you cool so power can remain available and reduce the chance of a community-wide outage.

• Vacuum air conditioner filters weekly during periods of high use. Air conditioner filters can become clogged or filled with dirt, making them
less efficient. Keeping them clean will allow your air conditioner to provide more cool air.

• If your home does not have air conditioning, go to a public building with air conditioning each day for several hours. Air conditioned
locations are the safest places during excessive heat because electric fans do not cool the air. Fans do help sweat evaporate, which gives a
cooling effect. However, when temperatures exceed 90o F (32 o C), fans become ineffective in reducing heat-related illness.

• Dress appropriately:
-Wear loose-fitting, lightweight, light-colored clothing that will cover as much skin as possible. Lightweight, light-colored clothing reflects
heat and sunlight and helps maintain normal body temperature. Cover as much skin as possible to avoid sunburn and the over-warming effects
of sunlight on your body.
-Protect your face and head by wearing a wide-brimmed hat. A hat will keep direct sunlight off your head and face. Sunlight can burn and warm
the inner core of your body.

• Drink plenty of fluids even if you do not feel thirsty. Drink regularly and often. Your body needs water to keep cool. Water is the safest liquid
to drink during heat emergencies. Injury and death can occur from dehydration, which can happen quickly and be unnoticed until too late.
Symptoms of dehydration are often confused with symptoms of other conditions.

• People who have epilepsy or heart, kidney, or liver disease; who are on fluid restricted diets; or who have a problem with fluid retention should
consult a doctor before increasing liquid intake.

• Avoid drinks with alcohol or caffeine. They can make you feel good for a little while, but they make the heat's effects on your body worse.
This is especially true about beer, which actually dehydrates the body.

• Eat small meals and eat more often. Large, heavy meals are more difficult to digest and cause your body to increase internal heat to aid digestion,
worsening overall conditions. Avoid foods that are high in protein, such as meats and nuts, which increase metabolic heat.

• Avoid using salt tablets unless directed to do so by a physician. Salt causes the body to retain fluids, resulting in swelling. Salt impedes sweating,
which helps keep you cool.

• Check on your animals frequently to ensure that they are not suffering stress from the heat. Make sure they are indoors or in the shade. Use fans
to cool areas that are not air conditioned or open to breezes. Provide plenty of water for drinking as well as for cooling the animals. If you see signs
of heat stress, call your veterinarian. Very young and older animals, as well as animals with short snouts, are more susceptible to problems with heat.

How to Make Your Home Safer for Occupants in a Heat Wave

• Install window air conditioners snugly. Insulate spaces around air conditioners for a tighter fit. An air conditioner with a tight fit around
the windows or wall openings will make less noise and allow less hot air in from the outside.

• Make sure your home is properly insulated. This will help you to conserve electricity and reduce your home's power demands for air
conditioning. Put weather stripping around doors and windows to keep cool air inside.

• Consider keeping storm windows installed throughout the year. Storm windows can keep the heat out of a house in the summer the
same way they keep the cold out in the winter.

• Check air-conditioning ducts for proper insulation. Insulation around ducts prevents cool air from leaking and keeps it directed through the vents.

• Protect windows from the sun. Hang shades, draperies, awnings, or louvers on windows receiving morning or afternoon sun. Outdoor
awnings or louvers can reduce the heat entering the house by as much as 80 percent.

• Use an attic fan. If you have a fan installed to vent warm air out of your attic, use it to help keep your home cool.

• Check buildings that house animals.

How to Recognize and Treat Heat Exhaustion and Heatstroke

Heatstroke

The signs of heatstroke in a person are hot, red skin; changes in consciousness; rapid, weak pulse; and rapid, shallow breathing. A person
experiencing heatstroke can have a very high body temperature—sometimes as high as 105°F (41° C). If the person was sweating from heavy
work or exercise, the skin may be wet; otherwise, it will feel dry.

Heatstroke is a life-threatening situation. If you suspect someone is suffering from heatstroke, call 9-1-1 or your local emergency number
immediately. Move the person to a cooler place. Quickly cool the person’s body— immerse it in a cool bath or wrap it in wet sheets
and fan it. Watch for signs of breathing problems. Keep the person lying down and continue to cool the body any way you can. If the person
refuses water, is vomiting, or exhibits changes in the level of consciousness, do not give him or her anything to eat or drink.

Do not give liquids that contain alcohol or caffeine because they can cause further dehydration, making conditions worse.

Heat Exhaustion

The signs of heat exhaustion in a person are cool, moist, pale, or flushed skin; heavy sweating; headache; nausea or vomiting; dizziness; and
exhaustion. A person experiencing heat exhaustion may have a normal body temperature, or it is likely to be rising.

If you suspect someone is suffering from heat exhaustion, move the person to a cooler place. Remove or loosen tight clothing and apply cool, wet
cloths, such as towels or sheets dipped in water. If the person is conscious, give him or her cool water to drink. Make sure the person drinks slowly.
Give a half glass of cool water every 15 minutes. Let the person rest in a comfortable position, and watch carefully for changes in his or her condition.

Do not give liquids that contain alcohol or caffeine because they can cause further dehydration, making conditions worse.

Heat Cramps

Heat cramps are muscle spasms that are caused by excessive sweating that results in a deficiency of salt. Although not as serious as heat exhaustion
or heatstroke, heat cramps sometimes precede them. If someone is suffering from heat cramps, move the person to a cooler place and have him or
her rest in a comfortable position. Lightly stretch the affected muscle and replenish fluids. Give a half glass of cool water every 15 minutes.

Do not give liquids that contain alcohol or caffeine because they can cause further dehydration, making conditions worse.

Heat Stroke in Animals

Animals are also susceptible to heat stroke, or hyperthermia, which is considered an emergency as it is with people. Signs in animals include
excessive panting; increased body temperature, heart rate, or respiratory rate; unusual salivation; collapse, stupor, seizures, or coma; redder
than normal mucous membrane (gums, for example); or capillary refill that is too fast. Be aware also of signs of dehydration, which is also an
emergency. For more information about first aid for cats and dogs, refer to Pet First Aid, by Barbara Mammato, DVM, MPH, a handbook
sponsored by the American Red Cross and The Humane Society of the United States. For information about other animals, ask your veterinarian.

If you suspect heat stroke, get the animal out of direct heat and spray it with cool water or place water-soaked towels on its head, neck, feet,
chest, and abdomen. The consequences of heat stroke may be life-threatening, but might not be visible to you for several hours, so take the
animal to your nearest veterinary hospital right away.

Media and Community Education Ideas

• Ask your local newspaper or radio or television station to:
-Do a series with information about excessive heat emergencies. Help the reporters to localize the information by providing the telephone numbers
of local emergency services offices, the local American Red Cross chapter, and nearby hospitals.
-Do a story featuring interviews with local physicians about the dangers of sunburn, heat exhaustion, heatstroke, and other conditions caused
by excessive heat.
-During a drought, run a series suggesting ways individuals can conserve water and energy in their homes and their workplaces.
-Interview local officials and representatives of the U.S. Department of Agriculture about special steps farmers can take to establish alternative
water supplies for their crops and ways to protect livestock and poultry from the effects of excessive heat.

• Sponsor a "Helping Your Neighbors" program through your local school system to encourage children to think of how they can help people who
require special assistance during severe weather conditions, such as elderly people, infants, or people with disabilities.

• Arrange for air-conditioned shelters to be opened when necessary for community members who do not have air conditioning at home.

• Arrange for special programs to provide air conditioners to vulnerable people in their homes.

Facts and Fiction

Fiction: Beer and other alcoholic beverages satisfy thirst in excessive heat.
Fact: Although beer and alcoholic beverages appear to satisfy thirst, they actually cause further body dehydration. You should limit your intake
of alcoholic beverages in excessive heat. Drink plenty of water. Your body needs water to keep cool. Drink plenty of fluids even if you do
not feel thirsty. (People who have epilepsy or heart, kidney, or liver disease; are on fluid-restricted diets; or have a problem with fluid retention
should consult a physician before increasing their consumption of fluids.)

Fiction: It’s always good to exercise, no matter how hot it is.
Fact: Many heat emergencies are experienced by people exercising or working during the hottest parts of the day. Reduce, eliminate, or
reschedule strenuous activities. If you must do strenuous activity, do it during the coolest part of the day which is usually in the morning
between 4:00 a.m. and 7:00 a.m.

Fiction: A heatstroke (sunstroke) is not life-threatening.
Fact: A heatstroke or sunstroke is life threatening. If someone has heatstroke, his or her temperature control system, which produces sweat
to cool the body, stops working. The body temperature can rise so high that brain damage and death may result if the body is not cooled
quickly.

Fiction: You will get sunburned only on really hot days.
Fact: Sunburn (and tanning) results from exposure to ultraviolet (UV) radiation, which is distinct from the light and heat emitted by the sun.
You cannot see or feel UV rays. They can, however, be quite damaging. UV exposure has been linked to skin cancer and other skin
disorders, cataracts and other eye damage, and immune-system suppression. The ozone layer absorbs most of the sun's harmful UV rays,
but this layer has thinned in recent years as a result of the emission of ozone-depleting chemicals. This thinning can lead to a greater chance of
overexposure to UV radiation.UV exposure is a year-round issue—you can sustain damage on the ski slopes just as easily as
on the beach, and clouds provide only partial protection. For more information, visit
http://www.epa.gov/sunwise.

To protect yourself:
- Limit time in the midday sun.
- Stay in shade.
- Use a broad-spectrum sunscreen of at least SPF15+ and reapply it every two hours.
- Wear a hat, protective clothing, and sunglasses.
- Watch for the UV Index (reported in local news and newspapers).

 

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