Are you a health care worker? We’d love to hear from you. Email editor at northcarolinahealthnews.org

By Thomas Goldsmith

A teenager growing up in Wilmington in the late 1960s and early ’70s sweated through about 40 days each year on which it was hotter than average.

In 2018, that teenager has now reached retirement age and feels the extra heat on about 70 days a year, an increase of 75 percent. That’s according to Climate Central, a nonprofit climate-study organization in Princeton, N.J., which analyzes data from NOAA and other sources.

Long term outlook forecasts from the National Weather Service are a graphic display of the confidence that a forecaster has, given as a probability, that the observed temperature, averaged over upcoming days will be either below normal, normal or above normal. This is a screenshot of the 6-10 day forecast dated July 9, 2018.

“In North Carolina, the three hottest summers on record back to 1895 were 2010, 2011 and 2016,” said Sean Sublette, meteorologist at Climate Central.

He also said that now, nights don’t cool off as much. “The nights when it stayed above 70 were about 20 back in 1970. Now that number is 70. It’s going to be harder to recover after the heat of the day.”

Health professionals warn that older people may feel the heat in different and sometimes unexpected ways. Experts at the National Institute on Aging recently pointed out health-related risk factors that can place older people at peril:

  • Sweat glands and circulatory systems that don’t relieve heat as well as they should;
  • Diseases that can cause fever or overall weakness, including those affecting the heart, kidney or liver;
  • Any condition that requires dietary changes, including salt restriction;
  • Medications including some heart and blood pressure drugs that could reduce sweating;
  • Carrying extra pounds, or being underweight; and
  • Alcohol consumption.

Hot-weather risks can lead to heat exhaustion and the much more serious heat stroke: A national study found that people between 65 and 74 averaged a 5 percent increased risk of death during heat waves; for people 75 and older, the average increased  risk of death was 8.2 percent. (The study defined a heat wave as temperatures greater than the 99.5th percentile for more than two days.)

“Rising, rising, rising”

“It is a very important public health concern,” said Dr. Graham Snyder, emergency physician at WakeMed in Raleigh. “The combination of older age and taking a lot of medications can put you at risk.”

People with dementia — and that includes as many as one-half of people older than 85 — might forget to pay an electric bill that makes air conditioning possible, Snyder said. Lack of money can also present problems for older people in heat waves; those without transportation can’t take a cooling trip to a shopping mall or swimming pool.

“Poorer people who may be stuck in an apartment can feel the temperatures rising, rising, rising,” Snyder said. “Someone with dementia might say, ‘I don’t feel good,’ but not know why. If you have elderly loved ones, it’s really important in the heat to check in with them.”

Screenshot of the homepage for the National Oceanic and Atmospheric Administration, grabbed on July 9, 2018.

Our aging teenager from Wilmington would likely be joined by people across the state in encountering more days of hot weather. In Greensboro, the increase in the number of above-normal days was from 33 to 68, more than double. In cooler Asheville, those days rose from 45 to 58.

Meanwhile, during the second week in July, the National Weather Service is predicting that temperatures will creep back up to the ’90s across North Carolina. Hospitals have already seen more than 1,300 people show up since early May because of generally rising temperatures.

In the week of June 17-23, nearly 500 people were seen in North Carolina hospital emergency departments because of the heat, as the National Weather Service posted maximum daily heat indexes at RDU from 97.4 degrees to 107.5 degrees.

Residents caught a break during the week of June 24 through June 30, when daily maximum temperatures dipped to a range of 77.7 degrees to 103.9 degrees and about 290 people visited hospital emergency departments with heat-related illness.

Tips for older people in hot weather:

The state Division of Aging and Adult Services has information about where people older than 60 can apply to get fans. In addition, the division advises older people to talk with doctors and other health professionals about medications, including painkillers, that can reduce awareness of dehydration and diuretics used for fluid loss. Additional tips from DAAS:

  • Cool off by taking baths or showers or placing ice bags or wet towels on the body.
  • Stay out of direct sunlight, put shades over the windows, and use cross-ventilation and fans to cool rooms.
  • Wear lightweight, light-colored, loose-fitting clothing that permits sweat to evaporate.
  • Drink plenty of liquids such as water, fruit or vegetable juices and iced tea to replace the fluids lost by sweating. As a person ages, thirst declines. Limit intake of alcoholic beverages or fluids that have too much salt, since salt can complicate existing medical problems, such as high blood pressure.
  • Eat small meals and eat more often and avoid foods that are high in protein which increases metabolic (body) heat.

Source: North Carolina Division of Aging and Adult Services

Of the two common heat-related conditions, heat exhaustion is the less serious. “A patient with heat exhaustion would present with vomiting, leg fatigue, cramping. You need to immediately get in the shade and get hydrated,” Snyder said. “Heat stroke is all of those things, plus confusion. If the person says he’s confused, that’s a heat stroke. You’re starting to talk about potential fatality.”

Heat rising in the East

Eastern North Carolinians typically feel more summer heat than people in other regions — Fayetteville experienced about 75 days of above-normal temperatures in 2015 before dipping to 62 in 2017. But increases will likely continue statewide unless national and worldwide energy practices change dramatically, said Sublette from Climate Central.

[sponsor]

“On our current path, without any change in the way we are burning energy, by the middle of the century we’ll see probably 10 to 20 days above 100, where we only have a handful — three or four days a year now — on average,” he said.

North Carolina’s Hottest Summers since 1895
  1. 2010
  2. 2011
  3. 2016
  4. 1900
  5. 1952
  6. 1934

Source: Climate Central

The federal Environmental Protection Agency is revamping its policies on climate change based on input from President Donald Trump, the EPA website says. The site refers visitors to an archived site from January, which says in part:

“Older adults are vulnerable to many of the impacts of climate change. They may have greater sensitivity to heat and contaminants, a higher prevalence of disability or preexisting medical conditions, or limited financial resources that make it difficult to adapt to impacts.”

A North Carolina-specific EPA fact sheet says the state, along with the rest of the Southeast, will see climate change likely to “reduce crop yields, harm livestock, increase the number of unpleasantly hot days, and increase the risk of heat stroke and other heat-related illnesses.”

Thomas Goldsmith

Thomas Goldsmith worked in daily newspapers for 33 years before joining North Carolina Health News. Goldsmith is a native Tar Heel who attended the UNC-Chapel Hill, and worked at newspapers in Tennessee...