Safeguarding against heatstroke during hot spell

By Sakini Mohd Said

KUALA LUMPUR: The hot spell Malaysia is currently experiencing may be a yearly phenomenon but it is something the public should not take lightly as it can have serious implications on their health.  

Continuous exposure to high temperatures over long periods can be fatal as it can lead to heatstroke.

Community medicine expert Prof Dr Sharifa Ezat Wan Puteh said extreme hot weather can cause excessive sweating and reduction of fluids in one’s body which, in turn, can lead to tiredness, lethargy and muscle cramps.  

If left untreated, dehydration would ensue. This condition is more serious as it can damage the body’s organs such as kidneys, brain, heart and liver and can lead to heatstroke.

According to the Ministry of Health’s website http://www.myhealth.gov.my/strok-haba-heat-stroke/, heatstroke can happen when the core body temperature rises to above 41 degrees Celsius due to continuous exposure to hot weather.

When an individual loses a large amount of water and mineral salts from his/her body, he/she will manifest symptoms such as faster heartbeat, rapid breathing and lowering of blood pressure.

Dr Sharifa Ezat said while sweating is the natural way of cooling down the body, excessive perspiration can lead to the loss of water and minerals such as sodium and potassium, all of which are important for the body’s physiological functions.

“For example, for normal body physiological functions, water is needed for the blood to circulate and to be pumped to and from the heart and filtered through the kidneys.

“And lack of minerals (in the body) can damage the nerve cells and heart which in turn can affect the person’s breathing and heart rate,” said Dr Sharifa Ezat, who is attached to Universiti Kebangsaan Malaysia’s (UKM) Faculty of Medicine.

High-risk groups

The current hot weather in Malaysia is a usual phenomenon that takes place between February and mid-April every year when the country is in the last phase of the northeast monsoon. 

According to the Malaysian Meteorological Department’s (MetMalaysia) website, nine areas in Peninsular Malaysia recorded yellow (alert) level heatwave as of 5 pm Saturday (March 6). The yellow level refers to a daily maximum temperature of 35 to 37 degrees Celsius for at least three consecutive days.

Elaborating on the health implications, Dr Sharifa Ezat said groups that face a higher risk of suffering from heat exhaustion or heat stroke include the homeless, senior citizens and pregnant women.

Overall, the risk of suffering from heat-related ailments is 10 times higher for adults aged 40 and above, children aged five and below and individuals with hypertension, diabetes and heart ailments.

Statistics cited by the World Health Organisation website showed that between 1998 and 2017, over 166,000 people, including 70,000 in Europe, died due to heatwaves.

Citing a report from the United States-based Centres for Disease Control and Prevention, Dr Sharifa Ezat said certain types of medications can also increase the risk of hyperthermia or heat stroke and heat-related death. These include antipsychotic drugs, sleeping pills, antihistamines, antidepressants and Parkinson’s disease medicines. 

Diuretics such as medications for hypertension and heart disease can result in frequent urination and loss of mineral salts which, during a heatwave, can easily cause dehydration to occur.

Other medications that can have a similar effect on the body are laxatives. Anticholinergics and beta-blockers (to treat heart disease) and medications for allergies, meanwhile, can reduce the body’s capacity to sweat and cool down the body.  

Temperatures not that high

Dr Sharifa Ezat said even though death due to heatstroke rarely occurs in Malaysia, high-risk groups should exercise caution during hot weather.

Among the measures one can take to protect oneself against the heat are increasing the intake of water, wearing light, loose and bright-coloured clothing, wearing a hat or using an umbrella when going outdoors.

Also, avoid drinking beverages containing caffeine and alcohol or with high sugar content. It is also not advisable to leave any person in a car with the windows wound up and the air-conditioning switched off.  

Dr Sharifa Ezat also suggested the following first-aid treatment for any person who shows symptoms of a heat-related problem whilst waiting for the victim to be sent to a clinic or hospital:

“Take the victim to a cool or shady area and place him/her flat on the ground. Lift up the legs so that they are higher than the chest level. Loosen the person’s clothes to improve air circulation and place a cold towel or ice on his/her neck, armpits and thighs to let the blood cool down. If the person has fainted, avoid giving him/her anything to drink and let the person lie on his/her side.”

Meanwhile, MetMalaysia director-general Jailan Simon said the highest temperature recorded during the period from Feb 1 to March 2 this year was 37 degrees Celsius on March 2 in Alor Setar, Kedah.

“This temperature, however, is lower than the highest temperature recorded in Alor Star, that is 39.1 degrees Celsius in March 1998 and 2016,” he said, adding that neighbouring countries such as Thailand, Indonesia, Vietnam and Cambodia are also currently experiencing hot spells. 

Climatologist Prof Dr Fredolin Tangang, who is attached to UKM’s Faculty of Science and Technology, said various factors contribute to the rising temperature during this period (February to mid-April) as the nation heads towards the equinox on March 20 when the sun crosses the equator (when day and night are of approximately equal length).

“Currently, the Malaysian and Indonesian regions are experiencing the suppressed phase of the Madden-Julian Oscillation (the intra-seasonal tropical climate variability) that emerged from the Indian Ocean and is moving towards the Pacific Ocean.

“The oscillation can lead to more rainfall (convective phase) or less or no rain (suppressed phase),” he said, adding that in the case of Malaysia and Indonesia, the US-based National Oceanic and Atmospheric Administration’s Climate Prediction Centre has forecasted dry and hot weather for at least two weeks from March 1. – Bernama