Extreme Heat Expected This Summer Is a Clear and Present Danger to Public Health

The summer solstice is one month away, and we are already seeing significant — and early — heat waves in the Pacific Northwest region. This pattern brings substantial concerns for yet another summer of prolonged heat waves with the risk of wildfires, poor air quality, drought and increased risks to health. While the summer is traditionally the warmest of our four seasons, climate change has resulted in extreme heat — summer environmental conditions that are supercharged to be hotter, more prolonged and more frequent than ever before.

Hotter-than-average temperatures are predicted this summer across the United States. Alarmingly, global temperatures are on track to reach new records in the next five years, according to the World Meteorological Organization, meaning facing more extreme heat — which is any pattern of several days or more that is hotter for a particular area than is usual for that time of year.

Because of the increased frequency of extreme heat, adapting to climate change is an unavoidable and necessary change in our day-to-day lives to avoid heat-related illness and death.

The health impact from this extreme heat can result in skin conditions such as heat rash and sunburn, to more serious conditions such as heat cramps, heat exhaustion and heat stroke.

Although preventable, heat-related illness results in over 600 deaths annually and causes many more serious illnesses. It causes more deaths than any other weather-related condition. Heat illness disproportionately affects the youngest and oldest in society, people with chronic health conditions and the disadvantaged because they have less capacity to protect themselves during extreme weather events.

Heat rash

Heat rash is a skin condition where blocked sweat gland pores trap sweat in the skin during hot weather. The rash is itchy or painful, with small blisters or inflamed lumps. It is also known as sweat rash, miliaria or prickly heat. It is treated by cooling and cleaning the skin, avoiding lotions or creams that block the skin’s sweat glands and wearing loose-fitting clothing.

Sunburn

Sunburn is an inflammatory condition caused by exposure to the sun’s ultraviolet (UV) rays. The UV rays cause damage consistent with first or second-degree burns. Inflammation, redness, itching, followed by blistering and eventually peeling of the epidermis, can all result. Significant sunburn can also be associated with broader systemic symptoms like fatigue, nausea, vomiting and, on occasion, fever and chills. Wearing light clothing to reflect the sun, a hat and sunblock with a sun protection factor (SPF) of at least SPF 30 is the best preventive measure for people who must be out in the sun. Acute sunburn is treated by ensuring adequate hydration, cooling the skin with cool cloths, soothing moisturizers that have aloe vera on the affected skin and anti-inflammatory agents. Uninfected areas of the skin can also be treated with 1% hydrocortisone creams.

Heat cramps

Heat cramps are painful involuntary muscle cramps that affect one or more muscle groups. They are caused by dehydration and intense sweating that results in electrolyte imbalances in the impacted muscles. It usually occurs with intense exercise in hot environments or in unacclimatized individuals in hot weather. Treatment, like for most heat conditions, is to move out of the hot environment to a cool shaded place and rehydrate with balanced electrolyte solutions. Stretching and massage of the impacted muscles can also be helpful.

Heat exhaustion

Heat exhaustion is caused by exposure to extreme heat with associated dehydration and body fluid loss. With heat exhaustion, the body’s ability to control body temperature is beginning to fail. It is associated with headache, fatigue, dizziness, heavy sweating and rapid pulse. An individual experiencing heat exhaustion may have an elevated temperature of as much as 104 degrees Fahrenheit but are typically still mentally aware. Other heat-related conditions like sunburn or heat cramps may be associated with it as well. Rapid removal from the heat and rehydration with balanced salt solutions is essential.

Heat stroke

Heat stroke is the most serious heat-related event and a true emergency. It is a life-threatening condition that presents with alterations of a person’s mental status or other central nervous system functions. Multi-organ failure, including kidney failure, destruction of muscle tissue and high fever of 104 degrees F or greater, rapid pulse and respiration, are all possible results. People experiencing heat stroke show the absence of sweating with dry, hot skin because their body’s ability to cool itself has failed. Emergency medical care, including immediate removal from the heat, rapid cooling, intravenous fluids and intensive medical monitoring.

Wildfires

Wildfires present another threat to the public’s health. In 2022, there were 66,255 wildfires that burned over 7,534,403 acres, according to the National Interagency Fire Center. In addition to the environmental impact of wildfires and the loss of property, wildfires are associated with poor air quality that worsen respiratory conditions like asthma, can precipitate heart attacks and cause direct injury from burns. Premature deaths are also a direct and indirect complication.

Climate change is fueling the growth in the size, scope and frequency of extreme heat events and is a clear and present danger to the public’s health. It requires our utmost attention.

Georges C. Benjamin, MD, is the executive director of the American Public Health Association based in Washington, D.C.