2023-07-14 15:02:00
Sportsmen, even young people, and workers who carry out intense outdoor activities. But also people in disadvantaged economic conditions, pregnant women who have a Covid infection or sequelae related to the coronavirus. And again: people taking certain types of medicines, those with alcohol or drug problems, chronic patients and even healthcare professionals. High temperatures can be insidious for health for various categories, not only the elderly who remain “however those who have a higher risk of complications due to a greater sensitivity to heat, a reduction in the thirst stimulus and a lower efficiency of mechanisms of thermoregulation”. The Ministry of Health lists the situations of greatest vulnerability to heat waves in the section of the site dedicated to the dangers associated with heat, where you can also read the ad hoc suggestions for each category.
Extreme heat conditions – it is explained – represent a health risk especially in population subgroups characterized by a limited capacity for physiological thermoregulation or reduced possibility of implementing protective behaviours. People vulnerable to heat, due to clinical, environmental and socio-economic factors, therefore, must be protected and monitored during heat waves. Infants and children, for example, due to the lower capacity for thermoregulation and the inability to express any discomfort related to environmental conditions, are more exposed to the risk of an excessive increase in body temperature and dehydration, with possible harmful consequences on the cardiovascular system , respiratory and neurological.
Even pregnant women are particularly vulnerable, the body in this phase undergoes a series of physiological changes: the increase in the volume of maternal blood, for an adequate blood flow to the placenta, requires sufficient hydration. The heat can cause dehydration, with the loss, through perspiration, of liquids and mineral salts which are precious for the maternal-fetal balance. Women who suffer from chronic illnesses or those who have pregnancy conditions, such as high blood pressure or diabetes in pregnancy, may be more at risk of giving birth prematurely.
Among people with chronic diseases, hypertensive and heart patients, especially the elderly, are most at risk from the heat. Diabetics, even if on drug therapy, are at risk of dehydration, especially in the case of peripheral neuropathy, because sweating is inefficient due to the interruption of the signal directed to the sweat glands. Finally, patients with severe renal insufficiency or on dialysis are more at risk since they can experience sudden changes in blood pressure more easily.
Among the vulnerable categories there are also people suffering from mental disorders, who, due to their lower degree of risk awareness, can engage in inappropriate behavior. Furthermore, it should be remembered that this group of people habitually uses drugs and this can aggravate the effects induced by excess heat. Persons with reduced mobility or dependents are particularly at risk because they depend on others to regulate their environment and fluid intake. A population particularly susceptible to heat waves is then that assisted in long-term care, nursing homes and nursing homes for the elderly, who must be ensured adequate monitoring of fluid intake, clinical parameters and the adoption of structural measures to temperature control.
Furthermore, some drugs interfere with the mechanisms of thermoregulation or influence the state of hydration. In particular medicines for hypertension and cardiovascular diseases; coagulation disorders; neurological diseases; psychiatric illnesses; thyroid disorders; chronic respiratory diseases. Heat risks also for people with addictions. The use of alcohol and opiates increases cutaneous vasodilation and increases sweating, reducing body temperature, but increasing the risk of dehydration. Additionally, alcohol acts as a potent diuretic leading to further excessive fluid loss and dehydration.
Even young people can have problems related to high temperatures, especially if they exercise or do intense work outdoors. People who perform intense outdoor work (for example agricultural workers, construction workers, transport workers, etc.) are more at risk of developing one of the disorders associated with heat.
Another group at risk of adverse effects from heat are social and health workers and all workers who perform essential services in hospitals and residential facilities for the elderly, as personal protective equipment can increase the risk of disturbances caused by heat. These workers must be particularly protected, for example with frequent breaks in cooled places, replenishing lost salts and liquids, scheduling the heaviest activities in the coolest hours, adopting lighter clothing.
Heat problems and disturbances also affect people infected with Covid or who have long-term sequelae of the disease. Lastly, poor socio-economic conditions make us vulnerable to heat waves. Poverty and loneliness can reduce awareness of the risks and limit access to emergency solutions. Furthermore, those who are poorer or more isolated have fewer possibilities of temporarily moving their homes to more favorable areas and fewer possibilities of conditioning the air in their homes.
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