Ensuring proper sleep of 7 to 8 hours in the night and cooler parts of early morning. An afternoon rest in a shaded place may be of further protective value. avoiding exposure to heat for extremes of age (less than 5 years or more than 65 years) and during pregnancy. Maintenance of general hygiene and sanitation, regular bath and care of skin, proper immunization and food/water hygiene to avoid git infections. Nutritious and palatable meals with plenty of drinking water. Treatment of skin conditions as prickly heat, psoriasis, sun burns etc.
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Reducing the amount of exercise in terms of duration or intensity or both. avoiding carrying of load or reducing the load. (b) Improving and maintaining the Individual Capacity to dissipate heat. This is achieved through, acclimatization to heat and proper hydration. (c) night avoiding Antecedent factors which increases write the risk. These include avoidance of obesity. avoidance of alcohol and other habit forming agents as cocaine, cannabis and caffeine. avoidance of self medication. seeking medical advice if medications have been prescribed by the physician. avoiding physical activity and exposure to hot environment during febrile illness, until fully recovered.
Specific Preventive measures Directed Towards Individuals and Small Groups Specific preventive measures directed to individuals or specific high risk groups as industrial workers, where military personnel, sports persons etc, are directed to achieve the following objectives :- (a) To reduce the "heat load" This is achieved. Micro climate cooling for certain groups like industrial worker, soldiers firefighters who have to undertake heavy exertion in hot environment and have to put on heavy clothing. Microclimate cooling systems cool down the micro-environment immediately surrounding the person rather than cooling the "macro environment that is, the general area of work. These systems use circulating cool air or cool liquid in tubes placed next to the skin or ice packed vests. seeking shade and wind to the extent possible. Frequent rest pauses interspersed between phases of physical activity. Putting on proper clothing of low insulation, low energy absorption and high permeability.
Below 23oC Low risk. In the absence of wbgt values, the oxford (WD) levels can be used as an approximate. A general guidance for outdoor exercises using wbt readings can be as follows (Table.9 - table.9 :Guidance for outdoor exercises using wbt readings wbt reading Action Less than.5oC Event can be held but with appropriate attention to providing drinking water and rest pauses.5. More than.5oC Cancel the event In case the Dry bulb (DBT) readings and relative humidity (RH) levels are known, a rough guidance for outdoor physical exercise can be as follows (Table.10) :- table.10 : rough guidance for outdoor physical exercise Dry bulbs temp. General Medical Practioners as well as public health / Occupational health specialists can effectively use the same in most of their routine settings. It is to be noted that all the above-mentioned meteorological parameters should be recorded as near the place of outdoor exercise as possible. It is also a known fact that large number of cases of heat illness occur in short period of time short and in specific localities. Occurrence of a large number of cases over a short period of time can lead to disaster like situation and contingency plans to deal with such situation should be kept in readiness.
Public health Surveillance, early warning Systems and Disaster Plan The need to have a good epidemiological surveillance system for heat illnesses as well as various environment conditions that determine those illnesses, need not be over emphasized. This should be established not only for specialized groups like armed forces or industries but also for the general community as well. It is only through ongoing collection of data and monitoring of trends of occurrence of illness and environmental factors, that proper policy decisions on public health aspects of heat illnesses can be taken 5,. An effective heat illness surveillance system must include reporting of all heat illness cases according to diagnostic categories, both for indoor and outdoor cases separately. It should have the minimum time and place of exposure, related data as well as basic clinical data, besides including the antecedent/precipitating factors, personal risk factors and the essential meteorological data (wbt, dbt, gt) according to time and for various locations. The data should be analyzed in an ongoing manner and a " heat and health early warning system" should be developed to issue early warnings and use of public health/preventive measures to the physician as well as to the general community. Simple warning criteria based on wbgt for outdoor exercises as running and cycling, for general public can be as follows (Table.8) 5: Table.8 : Simple warning criteria based on wbgt for outdoor exercises wbgt index Action Above 28oC Very high risk. Cancel all outdoor exercises. 23 to 28oC Persons at high risk of heat illness should not expose to outdoor exercise.
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Sports drinks are better than water. You can get enough cooling with a damp cloth around your neck or head. Salt tablets are good for preventing dehydration. In addition to providing the messages for simple dos and Donts, the general public should also be dvd made aware of whom to contact during an emergency (telephone numbers and addresses). Provisions of Basic Preventive amenities at Vantage points on a large Scale basis, during High Risk periods. There are four basic amenities which all public health managers must strive to provide to the general public during the hot weather or else, if some high risk activity as sports events or religious/social gatherings are likely. Cool drinking water at vantage points.
covered/shaded areas for taking rest pauses at vantage points. Facilities for first aid in a way that they are early accessible to all, particularly the high risk groups, and, Public information system to make all aware about the facilities and the telephone numbers/addresses of persons/first and facilities who may be contacted during need. Identification of High Risk Groups and Enlistment of Community support. Studies have revealed, there are certain high risk groups like agricultural workers, manual labourers, young children, old people those who are unable to care for themselves or do not have a family to care for them, those staying on higher floors of high rise buildings. And enlistment of community support as part of voluntary services with outreach efforts towards these high groups can be of much utility in minimizing the public health impact of heat.
Dress for hot, humid weather should be "breathable "i.e. Loose fitting, light weight, light colored, preferably of cotton material and in one or two layers only. Carry a water bottle with cool drinking water whenever you go out in summer months. If you feel exhausted, confused or running out of memory/consciousness, move to a shaded place, sit/lie down, drink cool water and seek help. Public Education should also seek to inform the community members of certain common myths and to resolve them, as shown in Box-2.5.2.
Box.5.2 : Public Education should also tackle certain myths;. Alcohol especially if chilled is good (or harmless) during hot weather. Track suits or windcheaters should be worn while doing sports or physical training. Tough people do not need to drink water. After acclimatization (getting used to) to heat, one can do well with only limited amounts of water. Drink water only when you are thirsty.
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Apply a sun screen ointment with a sun protection-factor (SPF) of at least 15, which should be able protect against both uv a and B rays, when going out in the sun. avoid alcohol consumption during hot humid months. If consumption becomes necessary, keep the same within limits of less than 2 small drinks of hard liquor or one bottle of light beer. Keep children less than 5 years and elderly (aged 65 years and above) away note from sun as far as possible. never leave children (or pets) in a closed, parked car. Try and park your car in cool, shaded place. Use a car sun visor to be minimize the effect of direct radiant heat produced by the sun, to enter inside the parked car.
If undertaking strenuous physical activities drink a quarter to half liter of water after every half hour, as long as strenuous activity continues. Do not wait for thirst to develop. Keep drinking water regularly even if not thirsty. If exposure to sun is necessary, place a wet hand towel around your neck. Put on a wide brimmed hat of light colour when going out. Simple caps as golf cap may not give enough protection. Put on sunglasses when going out in the sun.thesis
radio or television are less prone to developing heat illness, hence full use of audio-visual and print mass media must be made during the onset of hot weather and also well before the. The messages should include various aspects as shown in Box.5.1. Box 1: key issues for Public Education. Do not venture out in the sun, especially between 10 am to 4 pm unless the same is necessary. Avoid strenuous physical exertion between 10 am to 4 pm during the hot weather unless the same is necessary for reasons of occupation. Drink at least 4 to 5 liters of cool water is a day even if not feeling thirsty.
In such settings, heat related casualties may occur in large numbers in short duration (2 - 4) creating almost a disaster like situation and hence the need for public education, provision and quick first aid. From the public health point of view, the following aspects need to be addressed (a) Public education on various preventive measures. (b) Provision of basic preventive amenities at vantage points on a large scale basis, during high risk periods. (c) Identification of vulnerable groups in the community, driver enlistment of community support and outreach activities. (d) Issue of warnings as a part of "Heat and health" wearing system. (e) Public health surveillance. (f) Contingency plan for disaster.
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Rajvir Bhalwar, few of the worlds major population centres can afford to ignore the potential dangers of sustained heat wave. Every community should assess its resources and develop a contingency plan. Although heat stroke is amenable to medical treatment, control can best be achieved by applying the principles of public health. Sentinel surveillance, public education, outreach to vulnerable persons and enlistment of the help of the entire community can save lives. A structured approach filsafat towards prevention and control of heat illnesses in communities consists of : (a) Public health measures directed towards communities and large populations groups (b) Specific preventive measures directed towards individuals/small groups identified to be at high risk of heat illnesses due to certain occupational. Public health measures directed towards communities and large populations groups. Traditionally heat illness are associated with certain high risk groups, such as military personnel, industrial workers or sports person. A large majority of the worlds population lives in hot, humid tropical areas and are also at risk for classical forms of heat illnesses. In tropical countries like india, millions of people among the general population are at risk during the hot/humid months, especially when spells of heat wave strike.