By Cindy Krischer Goodman | [email protected] | South Florida Sun Sentinel
The brutal September heat and humidity in South Florida is sending people of all ages to the hospital and urgent care clinics.
Just last week, 15 students in McArthur High School's marching band reported being overcome by heat at an outdoor afterschool practice. Three of those students were transported to Joe DiMaggio Children's Hospital.
"All the students have recovered," said Cathleen Brennan, a communications officer for Broward County Public Schools. "The school's principal is reviewing safety protocols with the band director to prevent similar issues in the future."
Overheating is one of the most common and serious dangers in South Florida, a health concern that has become even more problematic this summer.
Thursday brought another day with the area under a heat advisory, warning that hot temperatures and high humidity may cause heat illnesses. Daily advisories this month caution that "feels like" temperatures are as high as 111 degrees in the afternoon and the risk for fainting, dizziness, and vomiting rises along with the more severe condition known as heat stroke. With heat stroke, the body temperature typically rises above 104 degrees and can lead to loss of consciousness and even death if not treated immediately.
Heat-related deaths have been increasing in the U.S. and in Florida as have heat-related emergency department visits, which are more numerous this summer than last in Florida and neighboring states, according to the U.S. Health and Human Services, which tracks extreme heat.
NASA data shows September 2023 was the hottest month on record in Earth's history and this September may beat that record. It is not just days that engulfed South Florida residents in sweat. Nights are hot, too, offering little relief from humidity.
Dr. Heidi Cohen, a pediatric emergency medicine specialist at Joe Dimaggio Children's Hospital, said that high humidity levels, in particular, put Floridians at risk.
"Ninety-five degrees in Florida is different from 95 degrees in Vegas," Cohen said. "The water you produce as sweat won't be absorbed as easily and cool you off. If sweat can't evaporate, then you don't get the cooling effect and you don't get the relief."
Cohen said the start of the school year can be challenging for children and teens who attend after-school sports practice and are not yet acclimated to spending hours outdoors in the heat. It can be more problematic for those students wearing helmets, pads, or other gear or clothing that traps the heat.
"Hydration is super important so when the heat index reaches a certain point, you need to take a lot of water breaks," Cohen said. "It's good to sweat, so when you stop sweating, that's a problem."
Cohen said signs of trouble include nausea, vomiting, stomach cramps, leg cramps, dizziness, and fainting. If someone displays those symptoms, "cool them off, have them walk into air conditioning, loosen their clothing, use cool compresses, put them in front of a fan ... basically, remove them from the heat and cool them down," she said.
Any escalation of symptoms is problematic. "If they are confused and delirious. If they look sick and there are signs their organs are starting to shut down, then they need to get immediate care," she said.
When those signs occur, 911 should be called.
Michael Kane, public information officer for the Broward Sheriff Fire Rescue & Emergency Services Department, said emergency medical service providers had already responded to seven heat-related incidents in the first week of the month, excluding incidents in Fort Lauderdale, Hollywood, and Coral Springs.
Urgent care centers are busy, too. Warmer temperatures can worsen asthma and respiratory conditions, lead to kidney injury and blood pressure problems, and aggravate kidney stones..
"Patients won't come in saying specifically that they have heat exhaustion or dehydration," said Dr. Ladan Pourmasiha, a family medicine physician and medical director for Baptist Health Urgent Cares in North Broward. "It's really the history and physical we do that determines it."
Pourmasiha said she has even seen cases this summer of rhabdomyolysis, the breakdown of muscle tissue triggered by heat stress and prolonged physical exertion. "They usually have to be sent to the hospital."
With heat-related illness, some patients complain of fatigue or extreme thirst. "They may be saying that they're starting to develop a mild headache and even tell you that they're not really urinating as much, and so those are the things that we look for," she said. "But when the person says that they have a mild headache, we already know that at this point they may be going from the dehydration stage to the heat exhaustion stage." If a patient is dizzy, lightheaded, or nauseous, Pourmasiha said they have progressed to heat exhaustion. "When it gets more serious, you will see a heavy amount of sweating," she said.
With heat stroke, she said. "You would expect them to be hot and sweating, but the body is starting to shut down. So these individuals will actually be cold and clammy and perspiration has actually stopped. This is where the body goes into shock and the blood pressure drops. Those are the cases where we want them to be seen in the ER immediately."
Outdoor workers need to use extra caution in September's extreme heat.
Ken Goldberg, CEO of All County Paving in Delray Beach, said his company takes precautions with its workforce year-round and even more when heat advisories go out.
"Generally, we are putting down black pavement and standing on black pavement," said Goldberg, whose crews are paving roads, parking lots, and sometimes even tennis courts. "Sometimes just walking away is like walking into air conditioning."
Goldberg said the company, which serves the entire state, provides workers with "cases and cases of water," Gatorade, sun-reflective long-sleeve shirts, and sunscreen, and requires mandatory breaks. He said Pedialyte is particularly helpful for fast hydration and has become a staple on jobs
Out on the asphalt, Goldberg said,his crews are well aware it has been hotter these summer months than in years past.
Vincent Carbe, general superintendent of All County Paving, said on South Florida days with heat advisories, workers do get overheated.
"You can tell when the heat is getting to them. The managers recognize it and send them to the truck with the A/C on and fluids."
Carbe said that if workers are in a confined area, they use umbrellas for shade, and big equipment used typically has air conditioning.
When possible, Carbe said the crews try to start early, well before the sun rises.