Emory Doctors Discuss "Killing Heat" In This W...( In an editorial in this week's New En...),Health

In an editorial in this week's New England Journal of Medicine, Emory University emergency physicians comment on lessons learned from the Chicago heat wave of 1995.

"Although heat stroke is amenable to medical treatment, control can be best achieved by applying the principles of public health," say authors Arthur Kellermann, M.D., and Knox Todd, M.D. "Sentinel surveillance, public education, outreach to vulnerable individuals, and enlisting the help of the entire community can save lives."

Older adults living alone and in the inner-city are at highest risk for heat stroke, as are persons who are infirm or shut-in, the authors say. Conventional practices like opening shelters or giving fans to poor citizens during heat waves are "not enough," they say.

"Unfortunately, the most well-intentioned efforts can be hampered by suspicion and fear," the authors say. "Air-conditioners have been turned off by victims who felt they could not afford the utility bill. Homes can become super-heated if the windows are nailed shut to thwart burglars. Some residents will not leave their home unguarded. Others are simply too proud or too fearful to seek refuge in a 'public' shelter.

"(Public) money spent on fans (for poor citizens) should be redirected elsewhere" since "...fans are useless when heat and humidity reach dangerous levels."

Based on their assessments of community response to the Chicago heat wave of 1995 and the Memphis, Tenn., heat wave of 1980, Dr. Kellermann and Dr. Todd make the following suggestions:

• "Since access to air-conditioning for even a few hours each day is protective, local governments in high-risk areas of the country should consider modifying their building codes to require every hotel and apartment building to provide an air-conditioned lobby."

• "Relatives, friends and neighbors can harbor more people than the largest public shelter."

• "Churches, synagogues and mosques can help by
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