1/5. Heat-related illnesses and deaths--missouri, 1998, and united states, 1979-1996.Although heat-related illness and death are readily preventable, exposure to extremely high temperatures caused an annual average of 381 deaths in the United States during 1979-1996. Basic behavioral and environmental precautions are essential to preventing adverse health outcomes associated with sustained periods of hot weather (daytime heat index of > or = 105 F [> or = 40.6 C] and a nighttime minimum temperature of 80 F [26.7 C] persisting for at least 48 hours). This report describes four heat-related deaths that occurred in missouri during 1998, summarizes heat-related deaths in the united states during 1979-1996, describes risk factors associated with heat-related illness and death, especially in susceptible populations (young and elderly, chronically ill, and disabled persons), and recommends preventive measures.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/5. Environmental hyperthermic infant and early childhood death: circumstances, pathologic changes, and manner of death.infant and early childhood death caused by environmental hyperthermia (fatal heat stroke) is a rare event, typically occurring in vehicles or beds. The aims of this study were to describe the demographics, circumstances, pathology, and manner of death in infants and young children who died of environmental hyperthermia and to compare these cases with those reported in the literature. Scene investigation, autopsy reports, and the microscopic slides of cases from three jurisdictions were reviewed. The subjects in 10 identified cases ranged in age from 53 days to 9 years. Eight were discovered in vehicles and 2 in beds. When the authors' cases were grouped with reported cases, the profile of those in vehicles differed from those in beds. The former were older, were exposed to rapidly reached higher temperatures, and often had more severe skin damage. The latter were mostly infants and were exposed to lower environmental temperatures. Hepatocellular necrosis and disseminated intravascular coagulation were reported in victims who survived at least 6 hours after the hyperthermic exposure. The consistent postmortem finding among nearly all victims was intrathoracic petechiae, suggesting terminal gasping in an attempt at autoresuscitation before death. The manner of death was either accident or homicide. Recommendations for the scene investigation are made.- - - - - - - - - - ranking = 3keywords = environment (Clic here for more details about this article) |
3/5. Criteria for the diagnosis of heat-related deaths: National association of Medical Examiners. Position paper. National association of Medical Examiners Ad Hoc Committee on the Definition of Heat-Related Fatalities.The National association of Medical Examiners Ad Hoc Committee on the Definition of Heat-Related Fatalities recommends the following definition of "heat-related death": a death in which exposure to high ambient temperature either caused the death or significantly contributed to it. The committee also recommends that the diagnosis of heat-related death be based on a history of exposure to high ambient temperature and the reasonable exclusion of other causes of hyperthermia. The diagnosis may be established from the circumstances surrounding the death, investigative reports concerning environmental temperature, and/or measured antemortem body temperature at the time of collapse. In cases where the measured antemortem body temperature at the time of collapse was > or = 105 degrees F (> or = 40.6 degrees C), the cause of death should be certified as heat stroke or hyperthermia. Deaths may also be certified as heat stroke or hyperthermia with lower body temperatures when cooling has been attempted prior to arrival at the hospital and/or when there is a clinical history of mental status changes and elevated liver and muscle enzymes. In cases where the antemortem body temperature cannot be established but the environmental temperature at the time of collapse was high, an appropriate heat-related diagnosis should be listed as the cause of death or as a significant contributing condition.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |
4/5. Heat intolerance induced by antidepressants.A case in which prescription medications induced heat intolerance which led to heat stroke is presented. A subject who suffered from depression and was treated with fluoxetine HCL (prozac) and lithium carbonate was engaged in mild intermittent work for 4 hours under hot/dry climatic conditions (Ta = 37 degrees C, rh = 15%). The subject lost consciousness, was hyperthermic and suffered from disseminated intravascular coagulation. A year later residual cerebellar symptoms were still evident and severe atrophy of the cerebellar tissue was demonstrated in a CT scan. It is suggested that drug-induced heat intolerance was the predisposing factor that reduced the patient ability to sustain exercise-heat stress, and under the favorable environmental circumstances led to excessive heat accumulation which ultimately caused heat stroke. This is the first description, to our knowledge, of heat intolerance of a patient treated by a combination of fluoxetine and lithium carbonate.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/5. Complications of fluid overload in heat casualty prevention during field training.Several troops evacuated from field training sites as heat casualties were determined to be fluid overload casualties. Common features of this paradoxical syndrome were dilute primary electrolytes with physical exhaustion and muscle weakness after rapid free water intake. A pattern of skipping meals, working in a hot and humid environment, and consuming large volumes of water as "protection against becoming a heat casualty" predisposed these troops to the physical impairment that they intended to avoid. The mechanisms leading to both appropriate and inappropriate physiological responses to free water replacement are discussed as a basis for avoiding this specific heat casualty situation.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |