A sunstroke death was confirmed for the first time in Kerala during a post-mortem conducted in 2007. The victim had suffered the stroke at Cherpulassery in Palakkad district. The following years saw eight more people succumbing to sunstroke in the state.
But raising more concerns, heat stroke claimed over 10 others during the same period. Majority of them were women. It may be noted that the heat stroke victims had not been exposed to direct sunlight. Most of these deaths occurred between March 20 and April 30.
Humidity is as crucial a factor as the atmospheric temperature in causing health issues. For instance, the damage caused by a mercury level of 36 to 38 degrees Celsius in the coastal areas with high humidity will be the same as a temperature of 40 degrees Celsius in Palakkad, a place with low humidity.
Heat exhaustion and heat stroke
Rising atmospheric temperatures affect people in two ways. Owing to excessive sweating, the body loses its water content and dehydration may occur. Moreover, a lot of salts and minerals present in the body will be lost through sweat. Most common is the loss of sodium.
When heat affects a person, he initially suffers heat exhaustion. Its signs are fatigue, weariness and muscle cramps, among others. When suffering from this first stage, drink plenty of fluids to make up for dehydration and loss of minerals. Rice gruel with a pinch of salt, lemon juice, buttermilk and tender coconut water are ideal.
Remove yourself from the area having high temperature. Take rest. These measures would be sufficient to tackle heat exhaustion.
However, if such a damage control exercise is not carried out, the condition of the victim may worsen and heat exhaustion may turn into heat stroke, which could prove fatal. A person suffering from heat stroke will not sweat at all as the body’s temperature control mechanism would have collapsed. The body temperature rises rapidly as if the victim has fever. Moreover, the pulse rate increases. If emergency medical care is not provided at this stage, it can be fatal.
With the mercury level shooting up in Kerala, even healthy people are at risk of heat stroke if adequate intake of water and minerals is absent.
Cause of death
Significant fall of the sodium level in the body can lead to loss of consciousness and even death. It has been noted that the number of people fatally collapsing during the February 15 – May 15 period is four times the figure recorded in the remaining periods. The major reason for such deaths is that due to dehydration, chances are high for people having high blood pressure and blocks in the arteries to suffer from a heart attack. Unfortunately, in majority of these cases, the role played by heat is overlooked.
A sunstroke victim can be identified during post-mortem. However, attributing a death to heat stroke or collapsing is not easy as in many of the cases there may not be visible symptoms. Chemical examination of the internal organs may have to be carried out to determine the cause.
Kitchen, a danger spot
heat stroke was found as the cause of death of three women who fatally collapsed in the kitchen between 1 pm and 5 pm. When the spot was checked, it was seen that the windows of the kitchen had been kept shut.
Another vulnerable area is the vehicle interiors. When a car is left under the hot sun with its windows half opened for one hour, the temperature inside rises to one-and-a-half times of that outside. Similarly, the mercury level inside closed rooms in concrete buildings and structures with a sheet roof will be higher than the outdoor reading.
The presence of water vapour formed during cooking and high temperature of the kitchen may combine to create conditions favourable to heat stroke.
» Drink plenty of water
» Ensure enough intake of minerals and salts, the impact of heat could be minimized
» Deaths may take place as the night temperatures go up from mid-March
» Till summer rains are received during the April-May months, avoid exposure to direct sunlight, especially during noon. Also do not engage in hard physical labour during these hours.
» Keep windows open at specific intervals.
(The author is Chief Consultant, Forensic Medicine and Police Surgeon, Palakkad)