Fact Sheet 

October 2007
 

During an average 

summer, approximately 

1,500 people die from 

excessive heat events in 

the U.S.1 A single heat 

wave in Chicago killed 

more than 700 people 

in 1995. In Europe, 

a record heat wave 

claimed an estimated 

35,000 lives in 2003. In 

both cases, most of the 

victims were 65 or older. 

“It’s Too Darn Hot” – 

Planning for Excessive 

Heat Events 

Information 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?2 

Anyone can be adversely affected by 

excessive heat, but older adults are 

particularly vulnerable. 

Excessive heat events are prolonged periods when temperatures reach10 

degrees Fahrenheit or more above 

the average high temperature for 

a region.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 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 body’s cooling 

mechanisms may become impaired. 

Living alone or being confined to a 

bed and unable to care for one’s self 

further increases risk. 

Existing health conditions such as chronic illness, mental impairment, 

and obesity can also heighten an 

individual’s vulnerability. Persons 

taking certain medications are 

likewise susceptible. 

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. 

“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.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. 

How Does Excessive Heat 

Affect the Body? 

The body normally cools itself by increasing 

blood flow to the skin and perspiring. Heatrelated 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 

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 customer’s electricity is turned off 

during a heat wave. 

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 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other References 

Environmental Protection Agency, 

Excessive Heat Events Guidebook 

Quick Tips for Responding to Excessive 

Heat Events 

http://www.epa.gov/aging/resources/epareports. 

htm#ehe_hw 

Poster: Beat the Heat—8 Simple Steps for 

Older Adults 

http://www.epa.gov/aging/resources/posters/index. 

htm#beattheheat-es 

Heat Island Reduction Initiative 

http://www.epa.gov/heatisland 

Center for Disease Control and Prevention 

http://www.cdc.gov/aging/ 

http://www.bt.cdc.gov/disasters/extremeheat/ 

http://www.cdc.gov/mmwr/preview/mmwrhtml/ 

mm5529a2.htm 

American Medical Association, Heat-Related 

Illness During Extreme Emergencies 

http://search.ama-assn.org/Search/query.html?qc= 

public+amnews+pubs&qt=heat 

National Weather Service, Heat Wave and Heat 

Index 

http://usasearch.gov/search?v%3Aproject=firstgov 

&query=heat+wave&affiliate=nws.noaa.gov 

Heat and Other Natural Hazard Statistics 

http://www.nws.noaa.gov/om/hazstats.shtml 

Heat Wave Awareness Project 

http://www.isse.ucar.edu/heat/ 

United States Department of Commerce, 

National Oceanic and Atmospheric 

Administration 

Heat Wave: A Major Summer Killer 

http://www.noaawatch.gov/themes/heat.php 

Endnotes 

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 Health 

Perspectives, 105(1):84-93. 

2	 Centers for Disease Control and Prevention, 

2003. Extreme Heat. Available online: 

http://www.bt.cdc.gov/disasters/extremeheat/ 

3	 Federal Emergency Management Administration, 

Backgrounder on Extreme Heat, Feb. 2003 

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. 

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 

Publication Number: EPA 100-F-07-025