Universität zu Köln

Leyk, Dieter, Hoitz, Joachim, Becker, Clemens, Glitz, Karl Jochen, Nestler, Kai ORCID: 0000-0001-5596-3427 and Piekarski, Claus (2019). Health Risks and Interventions in Exertional Heat Stress. Dtsch. Arztebl. Int., 116 (31-32). S. 537 - 550. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: With climate change, heat waves are expected to become more frequent in the near future. Already, on average more than 25 000 heat deaths are estimated to occur in Europe every year. However, heat stress and heat illnesses arise not just when ambient temperatures are high. Physical exertion increases heat production within the organism many times over; if not enough heat is lost, there is a risk of exertional heat stress. This review article discusses contributing factors, at-risk groups, and the diagnosis and treatment of heat illnesses. Methods: A selective literature search was carried out on PubMed. Current guidelines and expert recommendations were also included. Results: Apart from muscular heat production (>70% of converted energy), there are other factors that singly or in combination can give rise to heat stress: clothing, climate/acclimatization, and individual factors. Through its insulating properties, clothing reduces the evaporation of sweat (the most effective physiological cooling mechanism). A sudden heat wave, or changing the climate zone (as with air travel), increases the risk of a heat-related health event. Overweight, low fitness level, acute infections, illness, dehydration, and other factors also reduce heat tolerance. In addition to children, older people are particularly at risk because of their reduced physiological adaptability, (multi-) morbidity, and intake of prescription drugs. A heat illness can progress suddenly to life-threatening heat stroke. Successful treatment depends on rapid diagnosis and cooling the body down as quickly as possible. The aim is to reduce core body temperature to <40 degrees C within 30 minutes. Conclusion: Immediately effective cooling interventions are the only causal treatment for heat stroke. Time once lost cannot be made up. Prevention (acclimatiza tion, reduced exposure, etc.) and terminating the heat stress in good time (e.g., stopping work) are better than any cure.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Leyk, Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoitz, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Clemens UNSPECIFIED UNSPECIFIED UNSPECIFIED Glitz, Karl Jochen UNSPECIFIED UNSPECIFIED UNSPECIFIED Nestler, Kai UNSPECIFIED orcid.org/0000-0001-5596-3427 UNSPECIFIED Piekarski, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-144768
DOI:	10.3238/arztebl.2019.0537
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	116
Number:	31-32
Page Range:	S. 537 - 550
Date:	2019
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COLD-WATER IMMERSION; AMERICAN FOOTBALL; BLOOD-FLOW; COOLING METHODS; ILLNESS; EXERCISE; HEATSTROKE; STROKE; TEMPERATURE; HOT Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14476