Biology Reference
In-Depth Information
Of these, approximately 2% occurred when the maximum temperature
recorded at Raleigh Durham Airport was lower than 70°F, 3% when the tem-
perature was between 70° and 79°F, 23% when the temperature was between
80° and 89°F, 48% when the temperature was between 90° and 99°F, and 24%
when the temperature was 100°F or greater.
When the temperature was less than 70°F, men aged 18 to 64 comprised
approximately 31% of the total heat-related ED visits, a percentage that was
statistically indistinguishable from the percentage of males aged 18 to 64
in the population (28%). However, as the temperature increased, so did the
share of ED visits by men aged 18 to 64; from 42% at a temperature between
70° and 79°F up to 69% at temperatures exceeding 100°F. In contrast, at no
temperature did children aged 0 to 4 or adults aged 65 and older comprise a
share of total heat cases that was statistically greater than their proportion
of the population.
Roberts evaluated the free text field of the NC DETECT data to get a better
sense of why adult men were succumbing to the heat at such disproportion-
ate numbers. Based on information supplied by the patients and contained
in NC DETECT, she categorized male heat-related ED visits into those that
occurred at work, home, or during recreational activities; those that were
related to excessive alcohol consumption; and those among the homeless
(Figure 16.3). The majority of heat-related admissions among men were work
related, followed by a small surge among high school-aged boys who played
sports. Admissions related to other causes contributed only a small degree
to the surge of admissions seen in August 2007.
When Dr. Maillard received this information and shared it with other
senior staff at the Division of Public Health, they quickly realized that their
strategy to mitigate the impacts of heat waves was missing a key demo-
graphic group. Rather than children and the elderly exhibiting the greatest
observable impact from the heat, as had been the pattern in Chicago and
Western Europe in previous heat waves, North Carolina was experiencing
a surge in heat-related injuries among healthy working-age men. What was
different in North Carolina, and how could this information be put to use?
Health department staff speculated that farm laborers and construc-
tion workers might be responsible for the bulk of the surge in admissions.
Although not noticed at the time, the NC DETECT data reveal that 20.8% of
heat-related admissions in August occurred in the rural areas of Raleigh and
Kinston, North Carolina, where the bulk of the state's tobacco farming takes
place (U.S. Census Bureau 2009a). A 2008 CDC report supports the anecdotal
evidence from NC DETECT that farm-workers in general and tobacco farmers
in particular are at a highly elevated risk of heat-related illness because of
their need to wear thick protective clothing to avoid tobacco poisoning while
harvesting (CDC 2008).
Some observers speculated that the building boom of the mid-2000s might
also be contributing to the surge in emergency room admissions. In August
2007, North Carolina had issued more than 28,500 building permits over
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