US EPA
Fact Sheet - September 2004
During an average summer, approximately 1,500 people die from excessive 
heat events in the U.S. A singleheat wave in Chicago killed more than 700 
people in 1995. In Europe, a record heatwave claimed an estimated 35,000 
lives in 2003. In both cases,most of the victims were 65 or older. 

Its Too Darn Hot Planning for ExcessiveHeat EventsInformation for 
Older Adults and Family Caregivers
Did you know that each year more people die from excessive heat events 
than from hurricanes, lightning, tornadoes, floods, and earthquakes 
combined? Anyone can beadversely affected by excessiveheat, but older 
adults are particularly vulnerable.  Excessive heat events are prolonged 
periods when temperatures reach 10 degrees Fahrenheit or more above the 
average high temperature for a region.  Excessive heat events are believed 
to have a disproportionate public health impact in cities. One reason is 
that roads and buildings absorb the suns energy and contribute to the 
formation of heat islands.  While rural areas cool off at night, cities 
retain this absorbed heat. As a result, urban residents get less nighttime 
relief from high temperatures.  Fortunately, there are simple steps that 
older adults, their care-givers, and community leaders can take to decrease 
the impact of excessive heat events.  

Who is At Risk from Extreme Heat?

Older adults, as well as young children, are at high risk from excessive 
heat events. For the growing number of aging Americans, the bodys cooling 
mechanisms may become impaired. Living alone or being confined to a bed and 
unable to care for ones self further increases risk. Existing health 
conditions such as chronic illness, mental impairment, and obesity can 
also heighten an individuals vulnerability. Persons taking certain 
medications are likewise susceptible. 

Excessive heat events are surprisingly deadly. Vulnerable groups like 
older adults are at particularly high risk.  The good news is that there 
are simple steps people can take to protect themselves.

How Can I Reduce Exposure to Excessive Heat?The best defense against 
excessive heat is prevention. Air-conditioning is one of the best 
protective factors against heat-related illness and death.4Even a 
few hours a day in air conditioning can greatly reduce the risk.Electric 
fans may provide comfort, but whentemperatures are in the high 90s 
fans do notprevent heat-related illness. During excessive heat events, 
the followingprevention strategies can save lives: 
Visit air-conditioned buildings in yourcommunity if your home is not 
air-condi-tioned. These may include: senior centers, movie theaters, 
libraries, shoppingmalls, or designated cooling centers. 
Take a cool shower or bath.5
Drink lots of fluids. Dont wait until youare thirsty to drink. If a 
doctor limits your fluid intake, make sure to ask how muchto drink when 
its hot. Avoid beverages containing caffeine, alcohol, or large amounts 
of sugar. These drinks cause dehydration. 
Ask your doctor or other health care provider if the medications you 
take could increase your susceptibility to heat-related illness. 
Wear lightweight, light-colored, and loose-fitting clothing. 
Visit at-risk individuals at least twice a day. Watch for signs of 
heat-related illness such as hot, dry skin, confusion, hallucinations, 
and aggression.
Call 9-1-1 if medical attention is needed.

In addition, people who live on the top floors of buildings without 
air-con-ditioning are more likely to be exposedto excessive heat. 
Participating in stren-uous outdoor activities and consumingalcohol 
during unusually hot weatherlikewise exacerbates heat-relatedhealth 
effects.How Does Excessive HeatAffect the Body?The body normally 
cools itself by increas-ing blood flow to the skin and perspiring.  
Heat-related illness and mortality occurwhen the bodys temperature 
control system becomes overloaded. When thishappens, perspiring may 
not be enough.High levels of humidity can make it evenharder for the 
body to cool itself.How are Excessive Heat and Heat Stroke Related?  
Heat stroke is the most serious healtheffect of excessive heat events. 
It is the fail-ure of the bodys temperature control sys-tem. When the 
body loses its ability to coolitself, core body temperature rises 
rapidly.As a result, heat stroke can cause severeand permanent damage 
to vital organs. Victims can be identified by skin thatappears hot, 
dry, and red in color. Otherwarning signs are confusion, hallucinations,
and aggression. If not treated immediately,heat stroke can result in 
permanent disabil-ity or death. The good news is that heatstroke can 
be prevented by taking the easysteps outlined on this page.

What Can Your Local Government Do to Help?  Local governments can 
play an important role in predicting and responding to excessive heat 
events. Two increasingly common strategies are heat alert systems and 
heat reduction measures.  Heat Alert Systems Heat Health Watch-Warning 
Systems identify when a heat-related public health threat is likely. 
These systems use computer programs that analyze National Weather 
Service forecasts and other local data to predict dangerous conditions. 
Heat Health Watch-Warning Systems have been established in Philadelphia, 
Seattle, Chicago, St. Louis, and other cities in the U.S. and Europe.  
After a warning has been called, city health authorities communicate 
this information to older adults, their care-givers, and other at-risk 
groups. 

Assist the Homeless and Those With Mental Health Illness 
The following steps are best-practices that city officials can take 
to alert residents and provide direct assistance: 
Distribute media advisories 
Activate telephone hotlines 
Alert neighborhood volunteers, family members, and friends 
Provide air-conditioned buildings and offer transportation to these 
facilities 
Assist the homeless 
Work with local area agencies on aging to educate at-risk 
individuals 
Cities may also coordinate with local utilities to ensure that 
no customers electricity is turned off during a heat wave. 

How Does Extreme Heat Affect Me?
The body normally cools itself by increasing blood flow to the 
skin and perspiring. Heat-related illness and mortality occur 
when the bodys temperature control system becomes overloaded. 
When this happens, perspiring may not be enough.  High levels of 
humidity can make it even harder for the body to cool itself.

Learn More The EPA Aging Initiative is working to protect the 
environmental health of older adults through the coordination of 
research, prevention strategies,and public education. For more 
information or to join the listserve visit: 
www.epa.gov/aging

Other References
Environmental Protection Agency,Heat Island Reduction Initiative
http://www.epa.gov/heatisland

Center for Disease Control and Prevention http://www.cdc.gov/aging/
http://www.cdc.gov/nceh/hsb/extremeheat
http://www.cdc.gov/MMWR

Environmental Health Perspectives
http://www.ehp.niehs.nih.gov

American Medical Association,Heat-Related Illness During Extreme 
Emergencies
http//:www.ama-assn.org

National Weather Service, Heat Wave and Heat Index
http://www.nws.noaa.gov/pa/secnews/heat/

Medline Plus, Heat Illness
http://www.niapublications.org/spnagepages/hyperthermia-sp.asp

National Weather Service
http://www.nws.noaa.gov/om/hazstats.shtml

Heat Wave Awareness Project
http://www.esig.ucar.edu/heat/literate.html

Publication Number 100-F-04-008