A Doctor’s Playbook For Staying Safe In The Heat

The FIFA World Cup has returned to the United States alongside sweltering temperatures that could create a public health crisis across the country. Yesterday, in Washington, DC, I walked past the outdoor viewing station on the National Mall at 10:30 AM, and it was already 92 degrees. If you plan to enjoy matches outdoors, especially on the East Coast and in the South, where temperatures are expected to soar above 90 degrees Fahrenheit throughout the tournament, plan ahead to avoid heat exhaustion or heatstroke.

Why heat deserves your attention

Heat-related illness is the deadliest weather-related threat in the United States and claims more lives each year than floods, hurricanes and tornadoes combined. We don’t talk enough about the dangers of heat because its impact is less visible than a catastrophic flood or tornado that simultaneously affects thousands in a mass-casualty event covered on the evening news. The good news is that heat-related illness is almost entirely preventable if you know what to watch for and how to act.

What to know about heat exhaustion vs. heatstroke

Because heat illness can sneak up on you, it is important to know the difference between heat exhaustion and heat stroke. Heat exhaustion is the warning and precedes heatstroke. It happens when your body is losing water and electrolytes through sweating faster than you can replace them. The most common early signs are headache, dizziness and nausea. Before these symptoms appear, you may feel hot, irritable and thirsty.

One symptom many people overlook is the color of their urine. In a well-hydrated person, urine should appear pale yellow. If urine is dark yellow or approaching orange or light brown, this signals dehydration.

By contrast, heatstroke is a medical emergency. A person has heatstroke if they are hot to the touch and have stopped sweating. Other symptoms include confusion, slurred speech and fainting. If any of these symptoms occur, call 911 immediately, then, if possible, move the person to a shaded area while you wait.

Who is most at risk

Anyone can be affected by heat-related illness, but some people require heightened awareness. People over 60, people with obesity, high blood pressure and heart and lung disease are at high risk for heat-related illness. Often, people with underlying health conditions depend on medications that affect the body’s fluid balance and temperature regulation. Some people with high blood pressure or diabetes may underestimate how hot they actually are, which requires extra vigilance. Infants and young children are also vulnerable because their bodies are less efficient at cooling.

How to avoid heat-related illness

Talk to your doctor first. If you have a chronic condition like high blood pressure, heart failure or kidney disease, ask your doctor about a tailored hydration plan before heading to an outdoor event. Some medications affect how your body handles heat, so your doctor may have specific guidance for high-heat days.

Have a water plan. Don’t skip the loo. Staying hydrated is the key to avoiding heat-related illness. Some people skimp on water and beverages when outdoors because it may be inconvenient to find a bathroom. When temperatures are soaring, hydration must take priority over convenience because it is often difficult to gauge fluid loss when outdoors. In addition, intense, exciting soccer matches can be distracting and lead to overlooking subtle signs of dehydration. Some people may skip fluids to avoid bathroom breaks so they don’t miss the action. This attitude can endanger your health.

There is no single hydration formula that works for everyone. What matters is staying consistent. Plan water intake based on how long you expect to be outside in the heat. Aim to drink water at least every 30 minutes when outdoors even if you don’t feel thirsty. If it helps to remember amidst the excitement, set a phone alarm.

Be thoughtful about salty snacks. Eating a lot of salt pulls water from the body, which can increase fluid loss. Foods like chips, pretzels and cured meats often contain salt, which can quietly accelerate dehydration if you’re already sweating in the sun. If you’re snacking on salty foods, increase your water intake.

Mind your morning workout. Exercise is great but if you’ve had intense morning exercise or a workout, you may already be in a fluid deficit before you head to a match in the heat. This deficit can increase the likelihood of heat exhaustion and heatstroke. Prioritize rehydrating fully between your workout and heading out to the match.

Wear sunscreen. Apply SPF 30 or higher broad-spectrum sunscreen at least 30 minutes before sun exposure and reapply every two hours or sooner if you are sweating more than usual. A wide-brimmed hat can shield your face, neck and ears, and light-colored, loose, breathable clothing helps your body release heat more effectively than dark or tight fabrics.

Step out of the heat. Make it a habit to take shade breaks between noon and 4 PM, the hottest hours of the day. A few minutes indoors or under a canopy can help reset your body heat.

It’s In Your DNA

The theme for this year’s World Cup is: DNA- More than a game. The love for soccer may be in your DNA and more than a game, but staying healthy is what will keep you in the stands to enjoy the games. While you are monitoring the scoreboard, also scan your body to stay attuned to how you feel, because it’s in your DNA to receive signals when something is amiss. Throughout the tournament, be vigilant for your neighbors and yourself. Enjoy a safe and healthy FIFA World Cup!