By Dr Farooq Answer
In recent years we have seen unexpectedly severe heat waves that caused massive deaths in different parts of the world. In the 2003 European heat wave, more than 70,000 people died. Recently in 2015, a heat wave claimed 3,000 people in India and another 1,000 in Pakistan.
The Middle East generally has a very hot to warm climate. During summer, temperatures can reach up to 50 Celsius and conditions get worse with increased humidity.
The work force in this region comes from many regions, some that have cool or moderate weather. It is thus necessary to teach these people how to cope with the increased heat.
Heat related disorders are very common during the summer season with high temperatures and humidity and exposure of people with variable levels of fitness to these harsh conditions manifests itself in a varied picture of heat-related disorders, ranging from heat rash to heat stroke, which can be life threatening.
Heat related disorders comprise a spectrum of illnesses that results from excessive exposure to hot environment. These can be classified according to their severity in following types:
l Heat Stroke
l Heat Exhaustion
l Heat Cramp
l Minor Heat Illnesses
l Heat Syncope
l Heat Tetany
l Sunburn
Heat Stroke
Heat stroke can be fatal if not treated immediately in an intensive care environment. It occurs in two kinds of settings that are different enough to produce different clinical pictures and management.
The classical heat stroke occurs in individuals, frequently with impaired regulation of body temperature due to illness or medication, exposed passively to heat and dehydration. This form of heat stroke usually affects children, the elderly and debilitated people.
The exertional heat strike occurs in physically active individuals with increased endogenous heat load, for example outdoor workers, farmers, construction workers, and fire fighters etc. It can also effect indoor workers like furnace bakery workers, boiler workers, and iron smelting workers. People who take part in outdoor activities and games can also be affected.
Clinically, the primary difference between the two is that exertional heat stroke is complicated by Rhabdomyolysis (muscle breakdown) and renal failure.
Five organ systems are affected in a heat stroke: 1) Brain, 2) Muscles, 3) Kidneys, 4) Liver, and 5) Haemostatic system (the blood and vascular system).
The signs and symptoms of heat stroke include red hot dry skin, body temperature usually over 40.5 Celsius, nausea, vomiting, diarrhoea, weakness, dizziness, hyperventilation, blurring of
