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					                                                                                 April 2009

                            “It’s Too Darn Hot” –
Fact Sheet                  Planning for Excessive
                            Heat Events
                            Information for Older Adults and
                            Family Caregivers


                         D
                                   id you know that each     creates “heat islands” that are
                                   year in the United        hotter than areas outside of the
                                   States more people        city	and	don’t	cool	off	at	night.	
                                   die from excessive        In areas with fewer people,
                         heat than from hurricanes, light-   more trees and fewer streets
                         ning, tornadoes, earthquakes,       and buildings help things cool
                         and floods combined? 2              down overnight.
                         “An excessive heat event,” or
                         “heat wave” occurs when the         How Does the
                         summer heat is 10 degrees           Body Cool Itself?
                         higher than the average high
                         temperature for a region.3 For      Sweating, or perspiration helps
                         example, 95-degree weather          to cool the body. However,
 During an average       over several days in an area that   under some conditions,
                         averages 85 degrees would be        perspiration	just	isn’t	enough	
 summer, there are                                           and people stay hot. This
                         an excessive heat event, or heat
 more than 1,700 heat-   wave. This heat is unpleasant. It   can	cause	a	person’s	body	
                         is also especially dangerous for    temperature to rise rapidly.
 related deaths in the
                         older people. The longer high       When this happens, the very
 United States.1 In      temperatures last, the more         high temperatures can damage
 1995, a heat wave in    dangerous the heat becomes.         the brain or other vital organs.
                                                             High humidity, when the air is
 Chicago killed more
                         Where Are Heat Waves                full of water, makes it harder
 than 700 people. The
                         Most Dangerous?                     to sweat and cool the body.
 summer of 2003 in                                           Drinking alcohol or working or
                         Heat waves can be dangerous         playing outside during the heat
 Europe, a record heat   anywhere, but especially in         can also make it hard for the
 wave killed about       cities. Streets and buildings       body to cool down.
                         take in and keep the heat. This
 35,000 people. In
 both cases, most
 of the victims were                 Electric fans help to move the air,
 older adults.                       but they do not cool off the body
                                  when the temperature is in the high 90s.
                                                            off. Being overweight also
                                                            makes it harder for the body
What Can Be Done to                                         to cool off.

Help the Body Cool Off?                                     L
                                                         •	 	 ive	on	Top	Floors: People
                                                            who live on the top floors
                                                            of buildings are more at risk
Prevention is the best medicine. The best                   because heat rises and it is
way to avoid heat-related problems is to                    often warmer there than on
not get overheated.                                         lower floors.
                                                            N
                                                         •	 	 o	Air-conditioning:
   A
•	 	 ir	conditioning	is	the	best	defense.4                  People who do not have air
   Spending time in air conditioned                         conditioning are also likely
   location, (even a few hours); during                     to experience problems
                                                            during heat events.
   the hottest times of the day can be
                                                            B
                                                         •	 	 ed	Ridden: People who
   very	helpful.	If	you	don’t	have	air-                     are not able to get out of the
   conditioning in your home, visit family                  house and go to places where
   or friends who do. Go to the library,                    it is cooler are also at risk.
   a movie theater, a senior center, or a
   shopping mall. Check to see if your                   What Happens When the
   town has a “cooling center” which is                  Body Fails to Cool Down?
   a building with air conditioning where                When the skin cannot cool
   people can gather during a heat wave.                 down, body temperatures can
                                                         quickly get too hot. This can
•	 Take	a	cool	shower	or	bath.5                          cause a health problem called
                                                         “heat stroke.” Important organs
•	 	 rink	lots	of	fluids,	and	don’t	wait	
   D                                                     like the brain can overheat and
                                                         be damaged permanently. In
   until you feel thirsty. Drink regularly               some cases, this can lead to
   throughout the day and night.                         life-long disability or death.
                                                         Warning signs of being
                                                         overheated should be taken
                      Who is Likely                      very seriously. These signs
                      to Suffer Most                     include:
                      During a Heat Wave?                   R
                                                         •	 	 ed,	hot,	dry	skin	(lack	of	
                                                            perspiration)
                         O
                      •	 	 lder	Adults: As people get    •	 Confusion	
                         older,	the	body’s	ability	to	
                         cool itself may not work as        H
                                                         •	 	 allucinations	(seeing,	
                         well as it used to.                hearing, or smelling things
                                                            that	aren’t	there)
                         P
                      •	 	 eople	with	Health	
                         Problems: People who
                         are sick are at greater risk
                         of extreme heat. Some
                         medicines may make it
                         harder for the body to cool
                                                 Find out if your area has a Warning System
                                                 and how you can get more information.
    How Can I Keep Cool?                         Local governments also provide other
    •	 	f	your	heath	care	provider	asks	
       I                                         assistance. They can…
       you to limit the amount of fluids            L
                                                 •	 	 et	the	media	know	about	a	coming	heat	
       you drink, ask how much is safe              wave so it will be reported in the news.
       to drink when it is hot. Be sure             S
                                                 •	 	 et	up	telephone	information	lines	to	
       to find out an exact amount,                 answer questions about protection and
       such as “one 12-ounce glass”                 signs of illness.
       and how often.
                                                    T
                                                 •	 	 ell	people	how	to	help	an	older	family	
       A
    •	 	 void	beverages	that	contain	               member or neighbor during a heat wave.
       caffeine, alcohol, or large
       amounts of sugar. These drinks               M
                                                 •	 	 ake	air-conditioned	buildings	available	
       can overheat or dehydrate you.               and provide a way to get there.
       Ask your health care provider if             M
                                                 •	 	 ake	sure	that	homeless	people	can	find	
       your medicines might dehydrate               cool spaces.
       you. If so, find out what to do              M
                                                 •	 	 ake	educational	materials	available	
       about it. Do not stop taking your            to agencies, senior centers, places of
       medicine unless your doctor or               worship, and supermarkets.
       nurse says it is ok.
                                                    W
                                                 •	 	 ork	with	utilities	to	ensure	no	one’s	
       I
    •	 	f	you	live	alone,	be	sure	                  electricity is turned off during a heat wave.
       someone checks on you at least
       twice a day during a heat wave.
       Ask a friend or your caregiver to
                                                 What is EPA’s Aging Initiative?
       check for signs of heat-related           To help older adults enjoy a longer and
       symptoms, such as hot, dry skin,          healthier life and protect their loved ones, the
       confusion, or hallucinations.             EPA developed a program called the Aging
    •	 	 all	911	if	you	need	help	or	
       C                                         Initiative. It helps with research, develops plans
       medical attention.                        that cities can use to prevent sickness during
                                                 heat waves, and sponsors public education
                                                 about things in the environment that can affect
                                                 health.	For	more	information,	visit	the	EPA’s	
                                                 Web site at www.epa.gov/aging.
What are Heat Alert Systems?
Local governments can develop heat alert
systems and help protect the public from
heat-related problems.
Something called a “Heat Health Watch
Warning System” lets the public know when
a heat wave is coming. Local health officials
then get this warning out to older adults and
their caregivers and to others who might
suffer during a heat wave. These systems
have been set up in cities around the country,
including in Philadelphia, Seattle, Chicago,
and St. Louis.
                     How Can Communities Help Cool the Air?
    Communities can require the use of construction materials that do not absorb heat. When
possible, they can build roads and sidewalks using light-colored material that does not hold heat.
In addition, they can start programs to plant more trees and bushes. Each of these steps helps to:
	                              •	 Lower	the	air	temperature
	                              •	 Reduce	air	pollution
	                              •	 Decrease	energy	consumption
	                              •	 Improve	everyone’s	comfort




Other References                                  Endnotes
Environmental Protection Agency,                  1. Davis, R.E., P.C. Knappenberger, P.J.
Heat Island Reduction Initiative                     Michaels, and W.M. Novicoff. 2003.
http://www.epa.gov/heatisland                        Changing heat-related mortality in the
Centers for Disease Control and Prevention           United States. Environmental Health
http://www.cdc.gov/aging/                            Perspectives 111(14):1712-1718.
http://www.cdc.gov/nceh/hsb/extremeheat           2. Centers for Disease Control and
http://www.cdc.gov/MMWR                              Prevention, 2003. Extreme Heat. Available
Environmental Health Perspectives                    online: http://www.cdc.gov/nceh/hsb/
http://www.ehp.niehs.nih.gov                         extremeheat/default.htm
National Weather Service,                         3. Federal Emergency Management
Heat Wave and Heat Index                             Administration, Backgrounder on Extreme
http://www.nws.noaa.gov/pa/secnews/heat/             Heat, Feb. 2003
National Weather Service                          4. Naughton MP, Henderson A, Mirabelli MC,
http://www.nws.noaa.gov/om/hazstats.shtml            Kaiser R, Wilhelm JL, Kieszak SM, Rubin
                                                     CH, McGeehin MA. Heat-related mortality
American Medical Association,                        during a 1999 heat wave in Chicago. Am
Heat-Related Illness During Extreme                  J Prev Med. 2002 May;22(4):328-9.
Emergencies
http://www.ama-assn.org                           5. McMichael, A.J., L.S. Kalkstein and other
                                                     lead authors, 1996. Climate Change and
Heat Wave Awareness Project                          Human Health, (eds. A.J. McMichael,
http://www.esig.ucar.edu/heat/literate.html          A. Haines, R. Slooff, S. Kovats). World
Medline Plus,                                        Health Organization, and United Nations
Heat Illness                                         Environment Programme (Who/WMO/
http://www.niapublications.org/                      UNEP), Geneva, 297 pp.
spnagepages/hyperthermia-sp.asp




                                                    Publication Number EPA 100-F-09-019