D

id you know that each 

year more people die 

from “excessive heat 

events” than from 

hurricanes, lightning, tornadoes, 

combined? 2 Anyone can be 

adversely affected by excessive 

heat, but older adults are 

Excessive heat events are 

prolonged periods when 

average high temperature for 3 

Excessive heat events are 

believed to have a disproportionate public health impact in 

cities. One reason is that roads 

and buildings absorb the sun’s 

night, cities retain this absorbed 

heat. As a result, urban residents get less nighttime relief 

from high temperatures. 

steps that older adults, their 

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 

Americans, the body’s cooling 

mechanisms may become 

impaired. Living alone or being 

confined to a bed and unable 

increases risk. 

Existing health conditions such 

as chronic illness, mental 

also heighten an individual’s 

susceptible. 

“ ” — 

Planning for Excessive 

Heat Events 

During an average 

1,500 people die from 

excessive heat events 

in the U.S. 1 A single 

heat wave in Chicago 

Europe, a record heat 

wave claimed an 

estimated 35,000 lives 

groups like older adults are at particularly high risk. 

The good news is that there are simple steps 

people can take to protect themselves. 

floods, and earthquakes 

particularly vulnerable. 

temperatures reach10 degrees 

Fahrenheit or more above the 

a region.

energy and contribute to the 

formation of “heat islands.” 

While rural areas cool off at 

Fortunately, there are simple 

care-givers, and community 

excessive heat events. For the 

growing number of aging 

to care for one’s self further 

impairment, and obesity can 

vulnerability. Persons taking 

certain medications are likewise 

It’s Too Darn Hot 

Information for Older Adults and 

Family Caregivers 

Fact Sheet 

summer, approximately 

killed more than 700 

people in 1995. In 

in 2003. In both cases, 

most of the victims 

were 65 or older. 

“Excessive heat events” are surprisingly deadly. Vulnerable 

September 2004 
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.4 Even a few hours a day 

in air conditioning can greatly reduce the risk. 

Electric fans may provide comfort, but when 

temperatures are in the high 90s fans do not 

prevent heat-related illness. 

During excessive heat events, the following 

prevention strategies can save lives: 

•	 Visit air-conditioned buildings in your 

community if your home is not air-conditioned. These may include: senior centers, movie theaters, libraries, shopping 

malls, or designated “cooling centers.” 

•	 Take a cool shower or bath. 5 

•	 Drink lots of fluids. Don’t wait until you 

are thirsty to drink. If a doctor limits your 

fluid intake, make sure to ask how much 

to drink when it’s 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-conditioning are more likely to be exposed 

to excessive heat. Participating in strenuous outdoor activities and consuming 

alcohol during unusually hot weather 

likewise exacerbates heat-related 

health effects. 

How Does Excessive Heat 

Affect the Body? 

The body normally cools itself by increasing blood flow to the skin and perspiring. 

Heat-related illness and mortality occur 

when the body’s 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. 

How are Excessive Heat 

and Heat Stroke Related? 

Heat stroke is the most serious health 

effect of excessive heat events. It is the failure of the body’s temperature control system. When the body loses its ability to cool 

itself, core body temperature rises rapidly. 

As a result, heat stroke can cause severe 

and permanent damage to vital organs. 

Victims can be identified by skin that 

appears hot, dry, and red in color. Other 

warning signs are confusion, hallucinations, 

and aggression. If not treated immediately, 

heat stroke can result in permanent disability or death. The good news is that heat 

stroke can be prevented by taking the easy 

steps 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 

What Cost-Effective Steps Can 

Communities Take to Cool the Air? 

Two steps that communities can take include 

using construction material that reflect the sun’s 

rays, and planting trees and vegetation to provide shade and natural cooling. Both strategies 

reduce the urban heat island effect – urban 

temperatures 2-10 degrees Fahrenheit hotter 

than surrounding rural areas – and may limit the 

frequency, duration, and magnitude of excessive 

heat events. 

Heat reduction strategies such as using reflective 

“cool roofs” and light-colored pavements, and 

planting shade trees, have numerous benefits. 

These measures: 

•	 Lower ambient temperatures 

•	 Slow heat-driven reaction that forms 

ozone air pollution 

•	 Decrease energy consumption 

•	 Improve comfort and livability 

direct assistance: 

• Distribute media advisories 

• Activate telephone hotlines 

• 

members, and friends 

• Provide air-conditioned buildings and offer 

• Assist the homeless 

• 

to educate at-risk individuals 

Cities may also coordinate with local utilities to 

ensure that no customer’s electricity is turned 

off during a heat wave. 

The following steps are “best-practices” that city 

officials can take to alert residents and provide 

Alert neighborhood volunteers, family 

transportation to these facilities 

Work with local “area agencies on aging” 
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 body’s 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 

Footnotes 

1 Kallkstein, L.S. and J.S. Greene, 1997. 

An Evaluation of Climate/Mortality Relationships 

in Large U.S. Cities and the Possible Impact of a 

Climate Change. Environmental 

2 Centers for Disease Control and Prevention, 

2003. Extreme Heat. Available online: 

http://www.cdc.gov/nceh/hsb/extremeheat/ 

default.htm 

3 Federal Emergency Management Administration, 

Backgrounder on Extreme Heat, Feb. 2003 

Health Perspectives, 105(1):84-93. 

4 Naughton MP, Henderson A, Mirabelli MC, 

Kaiser R, Wilhelm JL, Kieszak SM, Rubin CH, 

McGeehin MA. Heat-related mortality during a 

1999 heat wave in Chicago. Am J Prev Med. 

2002 May;22(4):328-9. 

5 McMichael, A.J., L.S. Kalkstein and other lead 

authors, 1996. Climate Change and Human 

Health, (eds. A.J. McMichael, A. Haines, R. Slooff, 

S. Kovats). World Health Organization, and 

United Nations Environment Programme 

(Who/WMO/UNEP), Geneva, 297 pp. 

Publication Number 100-F-04-008