UCSF Sustainability Stories


Sophia Labeko


Surviving Extreme Heat

Recently, extreme heat warnings have been issued all over the country. While the temperatures vary from coast to coast, one thing is clear–this summer will be much hotter for all. May 2021 is already marked as the sixth hottest May on record.

Kevin Rolnick portrait Jeremy Lacocque portraitThese heat waves worry many physicians because they witness the associated illnesses and injuries firsthand.  To share some insight about health and safety during hotter-than-hot days, we spoke with Jeremy Lacocque, DO, Assistant Clinical Professor, UCSF Department of Emergency Medicine (pictured left) and Kevin Rolnick, resident, UCSF Department of Emergency Medicine ((pictured right).

What are some extreme heat related injuries and illnesses?
Lacocque: Almost all types of illnesses and injuries increase with prolonged heat exposure. Even when it’s a “nice” 72 degrees outside, it can be 10 degrees hotter inside because of how well insulated many of the homes are in San Francisco and lack of air conditioning. This means everyone, especially our vulnerable populations and those with chronic illnesses, can really suffer when we have a few hot days in a row. When people think of hot days, they think of things like heat stroke. That’s definitely a concern, but again, almost all types of illnesses and injuries increase with heat. We see more heart attacks, respiratory issues, kidney problems, psychiatric illness, and trauma when it’s warm outside. We also see indirect results of heat, like utility and power outages that affect people’s durable medical equipment, like home oxygen machines. No power can mean no oxygen which means they often have to come to the hospital.

As COVID-19 restrictions lighten and the weather gets warmer, more people are also going outside. While it’s great to enjoy the weather, we tend to see more traumatic injuries as well. So, make sure you wear a helmet and are safe near traffic, as we tend to see a lot of traffic-related injuries and unfortunately injuries from violence as well.

Who is more susceptible to these injuries and illnesses?
Lacocque: Anyone can suffer a heat-related illness, but those at risk include those with chronic illnesses, the elderly and young, those with physical disabilities, outdoor and manual workers, those experiencing homelessness, and those who otherwise have trouble caring for themselves.

Everyone should make an extra effort to check on one another - family, friends, neighbors, to make sure they are in a safe environment, have food, water, necessary medications, and ways to call for help, if needed. Opening your windows at night, if safe, can help cool your home and then closing them along with your shades during the day can help as well. If folks are not able to cool their homes effectively, going to a public space, like a public library with air conditioning, can help. Taking cool showers and hanging towels with fans can also help.

What are some signs of overheating? What does it feel like?
Rolnick: Overheating can cause a wide variety of symptoms. Some symptoms that can occur include fatigue, muscle cramping, headache, lightheadedness, syncope (passing out), and in severe cases confusion and disorientation.

What are some heat safety tips?
Rolnick: Look into local weather patterns and be prepared with adequate clothing to avoid sun exposure, bring water and/or sports drinks to replace water and salts lost from sweating, and plan your activities to moderate sun and heat exposure. Also be aware that overheating can occur even when you stay inside during a heat wave - especially in the Bay Area where air conditioners are not common. During a heat wave, consider limiting the use of stoves and ovens, when possible, to avoid increasing the temperature in your home.

Be sure to check in on your friends and family members who are less mobile or who are elderly to ensure they have what they need to endure the heat wave. If you’re concerned that you or someone you know is experiencing heat-related illness, don’t hesitate to seek emergency medical care.

What worries you the most about the heat wave happening all over the country?
Lacocque: The heat wave concerns me, but the bigger picture of global warming also concerns me. It seems every summer we go through this “scheduled disaster” of a heat wave and forest fires that is just so devastating to our communities. Not only people and their homes, but also the environment, pets, animals, wildlife, etc. Last summer when ash was “raining” on us in San Francisco, I couldn’t help but think that ash could’ve been from someone’s home burning down.

Rolnick: Among many concerns related to the current heat wave and climate change, one thing that concerns me most is that climate change is likely to disproportionately affect vulnerable populations that are already under-served in other social determinants of health, compounding the negative impact of climate change on these populations. We have to do more to address climate change, understand how it impacts health, and increase awareness of the interactions between environment and health. Everyone is a stakeholder when it comes to climate change and we need to take swift action!

What is the one thing you want people to know about extreme heat and health?
Lacocque: Heat related illness can happen even at mild temperatures like we have now in SF (low 70’s). It’s important to check on others and advocate for our vulnerable populations.

Rolnick: Health problems due to extreme heat are likely to be increasingly common due to climate change. Climate change also impacts health in many other ways. Take care of yourself and do your part to take care of the environment!

For more information about heat-related health issues and its impact on emergency services, watch Lacocque’s presentation for the UCSF Osher Mini Medical School for the Public.