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COLUMN: Know the risk factors of heat-related illness

B.C. heat victims in 2021 were mostly older adults with existing health concerns who lived alone
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Nelson’s Dr. Kyle Merritt has advice for people vulnerable to the heat. Photo: Submitted

by Dr. Kyle Merritt

After a cool and rainy spring, summer weather has emerged in the West Kootenay. This shift in weather presents an opportunity for us to reflect on the events of last year, acknowledge the health impacts related to global warming, and prepare for warmer temperatures in order to keep our communities safe.

Last year, we saw an unprecedented number of patients presenting with symptoms of acute and subacute heat stress in the Kootenay Lake Hospital emergency department. This trend was a result of the heat dome that we experienced in Nelson during late June to early July. This high-pressure system trapped hot air in our atmosphere for several days, with temperatures remaining stagnant throughout the evening and nighttime hours. In years prior, temperatures would normally drop off overnight, providing more opportunity for people to cool down.

The effects of the heat dome are particularly concerning for seniors and people who are living with mental illness and chronic illness. Medical frailty and social isolation can prevent people from seeking help and being able to cool themselves sufficiently. According to the BC Coroners Service, 619 deaths were identified as heat-related between June 25 and July 1, 2021 and were mostly older adults with existing health concerns who lived alone. Ninety-eight per cent of these deaths occurred indoors.

The coroner’s report calls our attention to the number of people in our communities who are isolated and our need as a community to adapt to the extreme weather conditions we are seeing as a result of climate change. I hope that these statistics will open the door for more dialogue about heat-related illness to encourage our community to implement strategies that will keep our most vulnerable members safe during times of extreme heat.

At temperatures above 31 C, the risk for heat-related illness grows substantially, especially in indoor environments. Persons with the following risk factors are particularly susceptible: age (60-plus years); mental illness or cognitive impairment; chronic disease; living alone or in social isolation; substance dependency or use; impaired or decreased mobility; medication use; poor physical fitness.

Using water is the easiest way to stay cool during periods of extreme heat. This can include taking a cool shower or bath or applying damp towels to help the body release heat. The most effective way to cool someone down is by using a spray bottle and a fan to promote evaporation of water on the skin. Also, it is important to stay hydrated by regularly drinking tap water with a source of salt to replace the electrolytes that are lost in sweat.

If you know someone who is at risk of heat-related illness, please check on them regularly this summer. Visiting in person is the best way to assess how someone is handling the heat, but if phone or digital media are the only communication avenues available, a remote health check is better than no health check. If you are unable to reach someone during a routine health check, take action by calling someone who can conduct an in-person health check or call 911.

For more information about health checks during extreme weather, please visit the National Collaborating Centre for Environmental Health at https://bit.ly/3OKh8qj.

Dr. Kyle Merritt is a family physician in Nelson and the emergency department head at Kootenay Lake Hospital. He is also the founder of Doctors and Nurses for Planetary Health Kootenay Boundary.

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