“Overexposure to the heat or the sun is underdiagnosed, because no patient goes to the emergency room saying they are hot”, says Dr. Elisenda Gómez-Angelats, deputy of the emergency department at the Clínic Hospital in Barcelona. This is the reason why, according to this doctor, the data recorded for overexposure to the sun from previous years are not very reliable.
However, Gómez-Angelats assures that there is more and more awareness that the heat can be the reason why so many patients go to hospital these days with headaches, a feeling of heat, shortness of breath, irritability, tremors, hypotension… and even a bit of a fever. In fact, we are suffering from what she considers a “heat epidemic” that, in terms of health, will accompany us every summer: “Heat is like colds in winter, it fills hospitals in summer”, says the doctor.
For this reason, the fact that doctors are increasingly aware that high temperatures can be the reason that these days more and more patients arrive with these symptoms and without any focus of infection will increase diagnoses due to overexposure to heat, explains Gómez-Angelats. Not only because this panorama of high temperatures will increase the incidence, but also because “there is more sensitivity when diagnosing on the part of doctors”, points out the doctor.
In addition, it is important to bear in mind that “heat stroke, per se, consists of being in a deep coma and at a body temperature of 40 degrees”, explains Gómez-Angelats, adding that this is only the tip of the iceberg, the most extreme case.
Before reaching this point, it goes through other phases, which produce the symptoms that are being seen frequently these days in the hospital.
In young people who have been exposed to a high level of heat or solar radiation, these generic symptoms may appear accompanied by leg cramps, abdominal pain, diarrhoea, tremors, convulsions or lipothymia (loss of consciousness). In elderly people, the range is even wider. In many cases, its symptoms are subtle: clumsiness, falls, weakness and drowsiness, which complicates detection.
“In people who are bedridden, for example, they usually realize why they are so sleepy, they try to wake them up and they don’t succeed”, explains the doctor, who emphasizes that it is not necessary to have been in the sun to suffer the effects of the heat. Added to this is less autonomy to express and recognize that they have been exposed to heat, because their thermoregulation is less effective.
For this reason, it calls for the need to closely monitor the population at risk both from families and from public health services. The latter specialize in prevention: it is recommended to avoid exposure during peak hours and aggressive physical activity, and it is encouraged to consume a lot of water and use cooling systems – soft cloths, create air currents with windows, fans or air conditioners. However, these measures are not equally accessible to the entire population.
“There are people who combine being older with not having the resources or autonomy to turn on a fan, and if they live alone, there is also no one who can help them put a towel of cold water on their forehead,” explains Gómez-Angelats. There are also those who, for work reasons, cannot take refuge; for them the medical recommendation is to hydrate, take breaks and wear a hat.
“We work on mortality for many causes and in the summer the peaks are usually low, but for a couple of years, especially in the past, the excess mortality in the summer has been very high and the vast majority of these deaths are attributed to the heat”, concludes Dr. Borràs, from the Vall d’Hebron University Hospital in Barcelona, ??who participates in the Health and Environment Committee that this health center started due to the advance of climate change.
