Killer Heat

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We are on the brink of summer, and the return of killer heat. Last year, 139 people died of heat-related causes in Arizona. Arizona Department of Health Services director Will Humble will talk about the killer heat, along with Arizona State University researcher David Hondula, who has a new report that studied the correlation between hospital room admissions and higher temperatures.

Ted Simons: 139 heat-related the deaths were reported last year in Arizona. With summer just about here we discuss the dangers of high heat with Arizona department of health services director Will Humble, along with ASU researcher David Hondula, who recently studied the correlation between hospital room admissions and higher temperatures. Good to have you both here. Thank you for joining us. This heat-related deaths business, 118 deaths per year usually, men seven out of 10, what's going on with men and heat-related deaths?

Will Humble: It's been that way for probably 20 years. Every year that we look at the data for heat-related deaths it's between two-thirds and three-quarters of them are men. Mostly in the 40 to 65 demographic, and up. But it's consistent every year, which is different from the rest of the country. You look at the rest of the country when they have heat-related deaths in places like Chicago, you don't see that gender bias the way we do here.

Ted Simons: Is it because we're just basically numbskulls, or -- I read somewhere that as men age, their ability to recognize they are dehydrated diminishes. Is that true?

Will Humble: That's one of the things we talked about before the show in the green room. One thing that may actually be going on is that men and women are both getting dehydrated and getting heat-related illnesses, but women go to the emergency department and get -- Seek care in time. Where men sort of -- Might be tending to say, well, I'll be OK. And it turns out they're not.

Ted Simons: You studied what happened in Australia regarding certain areas of cities in which heat deaths or heat-related illnesses seem to spike. Talk to us about that.

David Hondula: The first part of the story is that heat-related deaths are just the tip of the iceberg, the top of the pyramid for the total burden of heat on health. Here in Arizona when we look at hospitalizations versus death, we see about times more hospitalizations every year than we do for deaths. The same is true in Brisbane as well. In Brisbane we found that there is a relationship between temperature and hospitalizations, for every 10 degrees C, that's about 18 degrees Fahrenheit, the temperature goes up in the summer, hospital admissions increased by 7%. But that risk is not uniform across all of greater Brisbane. There's certain pockets within the city, and they're sparsely spread across BRiSBON where the risk is highest.

Ted Simons: Low-income areas I would imagine?

David Hondula: It turned out not to be low-income areas, but areas where there weren't a lot of high income earners. This seemed to tell a story that air conditioning is a luxury in BRiSBON that perhaps few can afford, and it's only in the places where air conditioning availability is high that we saw lower risk.

Ted Simons: I want to get back to that, but back now the idea of us numbskulls in the heat, what are the signs that it's getting to be a bit much, go get water, get into shade?

Will Humble: So the first thing I say is, by the time you're thirsty, you're already dehydrated. So people think I'm -- Once I'm thirsty I'll drink water. In the summertime in Phoenix, you're already on the downward slope to heat-related illness. So the key is to not be thirsty. Drink enough water so you don't get thirsty and then you can stay in that equilibrium where you'll be OK. It's really about -- If you know you're going to be outside during the heat of the day, camel up before you go out there. And just make sure that you're deliberate about drinking lots of water. If you do that, and if you're in generally good health, not on a lot of medications you'll probably be OK. We're trying to make -- I don't want people to get afraid of the Arizona heat. We want people to stay physically active and go out and get exercise, you just need to be smart about it.

Ted Simons: In BRiSBON, what as far as what you studied there, these different areas, it sounds like urban heat islands were a factor, you mentioned lack of air conditioning. How do they address that there?

David Hondula: That's a great question. We were talking about this before we came on. The different types of interventions that might be appropriate for different populations or in our BRiSBON studies case, different places. The strategy you might use for someone in a certain occupation, or someone likely to have been involved in outdoor activities like hiking, that would call for a different intervention strategy, encouragement to drink water, be smart about your behavior, than perhaps someone who lives in a neighborhood where they don't have access to air conditioning or they're unwilling or reluctant to use it for economic reasons. In that case you might maybe consider some subsidy program, maybe consider some sort of vegetation program that could help to reduce temperatures in those areas. I think we're continuing to learn that the more specific you can be for the most at-risk people the better.

Ted Simons: Does that make sense for Arizona?

Will Humble: It's a perfect public health intervention. That's exactly what we try to do in public health. Target your interventions for your high-risk populations, tailor them those to the needs of that population and then you have the best chance of being successful.

Ted Simons: I know you said camel up and try to -- If you know you're thirsty, you know you've gone too far. What are the symptoms after you're thirsty, some of the serious stuff?

Will Humble: Dizziness, vomiting or nausea, if your skin starts to really get red, that's a sign of serious heat-related illness. The final thing is when you get that sun stroke phase, you actually get pale and your skin gets dry. Any of those things, if they happen, are serious medical conditions you need to get to the emergency department. The real key is to be smart before you get to that stage. Take breaks, drink plenty of water, just be smart throughout the Arizona summer.

Ted Simons: As far as what's happening in Australia, you mentioned subsidies for maybe seniors or folks on fixed incomes. Are they looking at these ideas? Are they incorporating these ideas?

David Hondula: Those discussions happen, but a lot of it depends on the political climate in certain places. The types of programs you might be able to institute with respect to extreme weather and climate. So the climate in Australia and BRiSBON right now is not favorable for these sorts of programs for perhaps it will change in the future.

Ted Simons: Don't Brits, in Britain and U.K., they do the same thing for cold weather.

David Hondula: Cold is a big health hazard in Britain, and there are subsidy programs to help residents in certain parts of the U.K. afford their heating bills.

Ted Simons: So what can we do here in Arizona? I know donating water is always big when the temperatures get high.

Will Humble: Yes. One of the things we're doing as an agency at the department of health services we have a water donation drive that we're doing right now. We ask all of our employees to bring in water and that allows us to participate in the community, get those resources out to the city of Phoenix now that the -- At the heat relief stations. That's one approach you can help those vulnerable populations like the homeless to get access to water. In terms of the general population, it's just using that common sense to make sure that as you're going to be outside if you're going to be active, if you have an outdoor occupation, to really stay in tune with your body and stay hydrated.

Ted Simons: My last question, how do you stay active? I like to golf. I like to work in the yard. I don't want to sit around watching TV all summer because I'm in the air conditioning. How do you stay active and not put yourself at risk? You just basically carry around a big water jug?

Will Humble: That can work, right? If you get out early enough in the morning when it's still cool that's one strategy. If you want to go out later when the sun is not beating down that's another strategy. Staying hydrated throughout the day is another one. Another strategy is to go to the gym instead of working out outside. If you normally run in the winter, maybe use the treadmill. Find alternative strategies. There's a lot of things you can do inside the house for physical activity. There's lots of - There's different approaches for different people. Staying hydrated is always at that course the base of the pyramid.

Ted Simons: And water, what about Gatorade, water?

Will Humble: Water is like one-hundredth of a cent out of your tap.

Ted Simons: Is Gatorade good for you.

Will Humble: Well it depends. And there's a lot of sugar in some of them.

Ted Simons: That's true. Before you go, real quick, please do you want to add something?

David Hondula: Taking breaks as we discussed before the show. It's really important, the cumulative exposure can be particularly dangerous, any opportunity you have to take a break, whether it's getting into air conditioning or on the golf course finding yourself under a tree for a few moments, these measures can make a big difference.

Ted Simons: Finding myself under a tree on the golf course always happens! The easiest thing I can find is a tree. Good to have you both here. Thanks for joining us.

Will Humble & David Hondula: Thanks.

Will Humble:Director, Arizona Department of Health Services; David Hondula:Researcher, Arizona State University;

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