Cautionary Note on Heat-Related Illness

The following information is from the NYS Commission on Quality of Care and Advocacy for Persons with Disabilities. It was published in 2006, but is timeless advice for all of us, especially if we have family members or students on medications:

Heat-related illness occurs when one’s body is unable to properly cool itself, a task normally achieved through sweating. The elderly, children under the age of four, people with certain chronic illnesses and individuals on certain medications, including a wide range of anti-psychotics, anti-depressants, anti–cholinergics and mood stabilizers, are particularly at risk for heat-related illness, as their age, disability or medications may compromise their cooling mechanism. Young, healthy individuals, though, can also develop heat-related illness if they engage in strenuous activities in hot weather. Humidity also is a factor contributing to heat-related illness: when the humidity is high, sweat will not evaporate as quickly and the body cannot readily release heat. The two major categories of heat-related illness are heat exhaustion and heat stroke.

Heat exhaustion occurs when an individual is exposed for a prolonged period of time to high temperatures without an adequate or balanced replacement of fluids. Its symptoms may include heavy sweating, paleness, cramps, weakness, dizziness, nausea, cool moist skin and a rapid but weak pulse.

Left untreated, heat exhaustion can lead to heat stroke wherein the body is unable to control own temperature: the sweating mechanism shuts down and the body temperature rapidly rises to over 106 degrees. Heat stroke shares some of the symptoms of heat exhaustion (dizziness, nausea, etc.), but others are distinct. There is no sweating, the skin is hot and dry, the pulse is rapid and strong, and the victim loses consciousness. Without prompt emergency treatment, heat stroke results in permanent disability or death. Other less serious forms of heat-related illness are heat cramps and heat rash (prickly heat).

As an environmentally influenced cause of death, heat-related illness kills more Americans than hurricanes  (pre-Katrina), lightning, tornadoes, floods and earthquakes combined, according to the Centers for Disease Control and Prevention (CDC).


Heat-related illness is preventable; the key is staying cool and maintaining proper hydration. The CDC’s National Center for Environmental Health offers excellent advice on heat related illness, prevention and treatment on its web site:

Program operators who serve individuals at risk of heat-related illness, particularly those serving the elderly, infirm or people on psychotropic medications should visit the CDC’s web site for more information. Among other things facilities can do to ensure their clients’ well being in warm weather are:

  • Identify individuals who, because of age, medications, physical ailments, are at risk of heat-related illness.
  • Develop a heat policy for implementation when outside temperatures reach 80 degrees and ensure that all staff is aware of the policy.
  • Ensure that areas of the facility in which clients can be accommodated are air conditioned, if not all rooms are air-conditioned. In other areas, use ventilation systems and fans to keep air circulating. Note, however, that fans are not effective in preventing heat-related illness when temperatures are in the upper 90s.
  • Close windows and blinds/shades on sun-exposed walls, open windows on shaded walls, turn off heat generating
  • Encourage clients to avail themselves of cooler spots within the facility, or out in the community, i.e., air conditioned malls, libraries, movie theaters, etc.
  • Ensure that clients have access to and are encouraged to drink fluids. Discourage the intake of caffeinated  products, alcohol or overly sweet beverages.
  • Adjust menus, incorporating cold servings and food items that are rich in water, e.g. fruits, salads, etc.
  • Encourage clients to dress in light clothing and to avoid vigorous activities.
  • Monitor clients for signs and symptoms of heat-related illness.

Promptly seek medical attention when an individual displays signs and symptoms suggesting heat-related illness.