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Heat and heat related illness

Heat and heat related illness. Laurel Harduar Morano , MPH University of North Carolina School of Public Health Department of Epidemiology. Overview. Heat-Related Illness Environmental Parameters Epidemiology Work in Florida. The human body and heat.

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Heat and heat related illness

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  1. Heat and heat related illness Laurel HarduarMorano, MPH University of North Carolina School of Public Health Department of Epidemiology

  2. Overview • Heat-Related Illness • Environmental Parameters • Epidemiology • Work in Florida

  3. The human body and heat • Heat = byproduct of metabolic processes • Physical activity increases → energy consumption increases → more heat is produced • Heat absorbed from the external environment • Body gets rid of heat mainly through circulatory system and evaporation • Behavioral modification and adaption

  4. Heat Illness: Exhaustion/Stroke*

  5. Heat Stroke Types • Classical • High external Temperatures • Individuals whose thermoregulatory process is compromised • Individuals who lack ability to employ behavioral modification • Exertional • Strenuous activity (usually hot and humid weather) • Susceptibility = poor acclimatization, dehydration, heavy clothing, and underlying medical conditions. • Affects young healthy adults

  6. Heat-related illness (proxies) • Total morbidity or mortality • Circulatory disease • Cardiovascular • Stroke • Respiratory disease • Renal disease • Dehydration • Diabetes

  7. Environmental Parameters

  8. Environmental Parameters • Clothing insulation • Metabolic heat production • Ambient air temperature • Air velocity • Mean radiant temperature • Temperature from all sources • Humidity

  9. Heat proxy = temp or temp+humidityObtained from weather stations Florida North Carolina

  10. Epidemiology

  11. Epidemiology (US overview) • 1999-2003: 688 deaths/year due to extreme heat, hyperthermia, or both • 2009: 7,151 hospitalizations and 48,876 ED visits for heat-related illness • 2009: 35 occupational deaths (rate = 0.015/100,000 workers) and 2,170 injuries to workers requiring days away from work (rate = 2/100,000 full-time workers) • 2005-2009: estimated 9,237 high school athletes lost ≥ 1 days of activity due to dehydration, heat exhaustion, or heat stroke

  12. Occupational Epidemiology • High Risk: outdoor workers, firefighters, kitchen workers, miners, factory workers, soldiers, and metal smelters • 1998-2002: Hospitalizations = 20/100,000 US Army soldiers; Death: 0.3/100,000 US Army soldiers • 1995-2005: Washington workers’ comp -fire protection (rate = 80.9/100,000 FTE), roofing construction (rate = 59.0/100,000 FTE), and highway, street and bridge construction (rate = 44.8/100,000 FTE) • 1992-2006: 57% of crop worker death occurred in California, Florida, and North Carolina

  13. Risk Factors • Age • Elderly and very young • Gender • Race/ethnicity • Socio-economic status • Medical factors • Air-conditioning • Urban Heat Islands

  14. Florida

  15. Selected characteristics of Florida residents diagnosed in a Florida hospital or ED with HRI and characteristics of Florida population, 2005-2009 (N=18,572) †Note 136 individuals did not report their race/ethnicity.

  16. Selected characteristics of Florida residents diagnosed in a Florida hospital or ED with HRI and characteristics of Florida Workers, 2005-2009 (N=2,198) †Note 14 individuals did not report their race/ethnicity.

  17. Distribution of rates of heat-related hospitalizations and ED visits by age group among Florida residents, 2005-2009 (N=18,572)

  18. Distribution of age group by rates of occupationalHRI hospitalizations and ED visits among Floridians, 2005-2009 (N=2,198) Rate per 100,000 worker Age group (years)

  19. Exposure Assignment Apopka Orlando Avalon

  20. Estimated non-occupational heat-related illness incidence rate/1,000,000 person-days

  21. Estimated non-occupational heat-related illness incidence rate per 1,000,000 person days days

  22. Questions? • Laurel HarduarMorano, MPH • harduarm@email.unc.edu

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