Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2022
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2022
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Practice

Heat-induced illness

Christina Simpson and Alan Abelsohn
CMAJ July 10, 2012 184 (10) 1170; DOI: https://doi.org/10.1503/cmaj.120492
Christina Simpson
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: christina.simpson@hc-sc.gc.ca
Alan Abelsohn
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading

Extreme heat causes a substantial number of deaths

The European heat wave of 2003 resulted in more than 70 000 deaths, 28.9% of which were attributed to heatstroke, hyperthermia or dehydration.1 Extreme heat recently contributed to 106 deaths in Montréal, Quebec, and 156 deaths in Vancouver, British Columbia.2 Extreme heat events are expected to become more common in Canada as the climate continues to change. Increased health risks from extreme heat can be induced by high temperature and humidity, and can be exacerbated by other factors such as air pollution or a person’s underlying physiology.3 Urban areas are more affected because of the “urban heat-island effect.”3

Many people are vulnerable to heat

Case–control studies have identified people with chronic physical conditions (cardiovascular, pulmonary, renal and neurologic disease, diabetes and obesity) and those with mental illness as vulnerable to extreme heat because of their underlying physiology.4 Older people, children and people who are very physically active in the heat are also at higher risk for heat-related illness.5 Common drugs such as antipsychotic agents, antidepressant medications (e.g., selective serotonin reuptake inhibitors, lithium), diuretic agents, antihistamines, anticholinergic agents and anti-Parkinson agents can increase risk by interfering with thermoregulatory mechanisms.6

It is important to differentiate heat exhaustion from heatstroke

Heat exhaustion is the most common heat illness. Although the patient may have hot skin and be flushed and sweating, his or her core temperature is below 40°C. In heatstroke, the core temperature is above 40°C, the patient’s mental status may change, and he or she may become incoherent or unconscious. In classic heatstroke, the skin is usually hot, red and dry; in exertional heatstroke, there is profuse sweating after high-intensity physical activity.7

Heatstroke is a medical emergency

Heatstroke can progress rapidly to multiorgan dysfunction and death. Treatment must be immediate and consists of rapid cooling (evaporative cooling for classic heatstroke; ice-water baths for young adults and people with exertional heat stroke).7 Careful attention should be paid to the patient’s hydration and electrolyte balance to restore blood pressure and tissue perfusion.3

Death from heat exposure is preventable

Observational studies support increasing fluid intake and reducing activity levels during hot weather, and cool or air-conditioned environments for people most vulnerable to heat.5 Various Canadian communities have implemented heat alert and response systems that include issuing public health messages, opening cooling centres and extending hours for public swimming pools.

Resources

  • E-learning module on the health impacts of extreme heat (www.extremeheat.ca).

  • Climate change and health (www.healthcanada.gc.ca/cc).

Footnotes

  • Competing interests: None declared.

  • This article has been peer reviewed.

References

  1. ↵
    1. Hémon D,
    2. Jougla E
    . The heat wave in France in August 2003. Rev Epidemiol Sante Publique 2004; 52:3–5.
    OpenUrlPubMed
  2. ↵
    1. Kosatsky T
    . Hot day deaths, summer 2009: what happened and how to prevent a recurrence. BMCJ 2010;52:261.
    OpenUrl
  3. ↵
    1. Luber G,
    2. McGeehin M
    . Climate change and extreme heat events. Am J Prev Med 2008;35:429–35.
    OpenUrlCrossRefPubMed
  4. ↵
    1. Bouchama A,
    2. Dehbi M,
    3. Mohamed G,
    4. et al
    . Prognostic factors in heat wave related death: a meta-analysis. Arch Intern Med 2007;167:2170–6.
    OpenUrlCrossRefPubMed
  5. ↵
    1. Hajat S,
    2. O’Connor M,
    3. Kosatsky T
    . Health effects of hot weather: from awareness of risk factors to effective health protection. Lancet 2010;375:856–63.
    OpenUrlCrossRefPubMed
  6. ↵
    1. Cuddy ML
    . The effects of drugs on thermoregulation. AACN Clin Issues 2004;15:238–53.
    OpenUrlCrossRefPubMed
  7. ↵
    1. Bouchama A,
    2. Dehbi M,
    3. Chaves-Carballo E
    . Cooling and hemodynamic management in heatstroke: practical recommendations. Crit Care 2007;11: R54–64.
    OpenUrlCrossRefPubMed
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 184 (10)
CMAJ
Vol. 184, Issue 10
10 Jul 2012
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Heat-induced illness
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Heat-induced illness
Christina Simpson, Alan Abelsohn
CMAJ Jul 2012, 184 (10) 1170; DOI: 10.1503/cmaj.120492

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Heat-induced illness
Christina Simpson, Alan Abelsohn
CMAJ Jul 2012, 184 (10) 1170; DOI: 10.1503/cmaj.120492
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • Extreme heat causes a substantial number of deaths
    • Many people are vulnerable to heat
    • It is important to differentiate heat exhaustion from heatstroke
    • Heatstroke is a medical emergency
    • Death from heat exposure is preventable
    • Footnotes
    • References
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Methemoglobinemia in a 28-year-old woman treated with dapsone
  • Methemoglobinemia caused by sodium nitrite overdose
  • Fixed drug eruption
Show more Practice

Similar Articles

Collections

  • Topics
    • Public health

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
  • Accessibiity
  • CMA Civility Standards
CMAJ Group

Copyright 2022, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: cmajgroup@cmaj.ca

Powered by HighWire