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COMIC: How excessive heat kills and how to stay safe

1 hour ago 1

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Of all extreme weather conditions, heat is the deadliest. Human bodies have a natural cooling system — sweat — but that system can do only so much in high temperatures and humidity.

But how exactly does heat kill? Here's the science behind what happens to the body in extreme temperatures, including the three main ways heat can shut down vital systems, as well as tips to stay safe, cool down and fend off heatstroke.

NPR health correspondent Maria Godoy, a woman with long dark hair, fans herself. The sun is out, and she’s sweating a lot. Sweating it out this summer?, she asks. Sweltering heat can not only be irritating — it can be deadly.

Extreme heat kills more people in the U.S. in an average year than hurricanes, tornadoes and floods combined. Let’s break down the main ways that heat can kill and the signs of danger.

Below, Godoy floats in a cloud of suffocating heat. Three arrows point out from her at icons of the stomach, heart and kidneys.

When your body is exposed to high heat, it tries to cool down by sweating and by redirecting more blood to the skin. But that means less blood and less oxygen go to your gut. A diagram of the human body, with arrows pointing out to the skin and away from the stomach, sweats and looks uncomfortable.

This can happen in dry heat too, but high humidity can make it harder for your body to cool off. That’s because sweat doesn’t evaporate as well when it’s humid. Godoy looks relieved as she sweats and the sweat evaporates, cooling her down. Next to her, a sign says that the temperature is high (90 degrees Fahrenheit) but the humidity is low (10%). Then she sweats again, but now the humidity is 85%. Her sweat doesn’t evaporate, and she looks hot and tired.

If the redirection of blood happens for too long, your gut can become more permeable. Toxins that usually stay inside the gut start leaking out. We zoom in on an image of a stomach with toxins passing outward.

These toxins can trigger inflammation and other effects, like blood clots, that eventually can lead to multiple-organ failure. A full-body diagram of a sweating, ill person shows a progression from toxins circulating around the body to a blood clot and then to organ failure.

When your body pumps more blood to the skin to cool itself, arteries widen, lowering blood pressure. This means the heart has to work harder to keep blood pressure up. Similar to a previous page, a full-body diagram of blood going to the skin shows the person sweating and looking uncomfortable. Then we zoom in on a cross section of an artery, which is widening as more blood pumps through, and then a heart shape steadily beating faster and faster, sweating.

This added stress on the heart can trigger a heart attack or stroke. Godoy clutches at her chest, breathing hard. Older adults and people with underlying heart conditions may be at higher risk. Godoy talks with a crowd of people of different ages, genders and races.

55% plasma, which is mostly water; 1% white blood cells and platelets; and 44% red blood cells. Then, your heart and kidneys need to work harder to maintain blood pressure, which can lead to kidney failure and can be fatal. The full-body diagram from earlier sweats as the person's kidneys give out.

a man hammering the ground; people gardening and landscaping; and a woman and her small child hiking.

How hot is too hot? There’s no absolute temperature at which extreme heat can turn dangerous. Here’s what to watch out for. It’s riskier if you’re not acclimated to high heat; a tourist sweats as he consults a map. The longer you’re exposed, the higher the risk; a runner checks her watch after running outside for two hours. People can become overwhelmed sooner in high humidity than in dry heat; a man with box braids pushes them off his forehead in the wet heat. Stay in the shade — direct sunlight heats us up faster; two people seek shade under a tree.

Who is most at risk? Young children, whose bodies are still learning to regulate temperature; older folks, who may have a reduced ability to sweat, and people with chronic conditions like heart disease; people who do strenuous physical activity outdoors; pregnant women, whose bodies have to work harder to regulate temperature. But know that even young, healthy people can succumb to extreme heat.

What should you watch out for? Keep an eye out for the first signs of heat exhaustion: headaches, dizziness, lethargy and feeling unwell in general. Godoy clutches her head, feeling dizzy and low energy.

How to stay safe. Drink plenty of water before you head into the heat and every 15 to 20 minutes when you’re physically active in the heat. Godoy drinks water, heads outside and then drinks water again.

If you start to feel overheated, wet your clothes and skin or immerse your feet in cold water. Seek shade, or better yet, head to a cool spot indoors. Godoy sits down with her feet in a bucket of water. A teen boy massages her shoulders with a wet cloth, while a young girl runs over with an umbrella for shade.

The goal is to cool down so heat exhaustion doesn’t progress. Signs of that include vomiting, rapid breathing, confusion and loss of coordination. Godoy collapses onto a table, panting and looking extremely unwell.

If your core body temperature rises to about 104 degrees Fahrenheit, you risk heatstroke, which can be deadly. So keep an eye out for heat advisories in your area. Staying alert can help you stay safe. Godoy sits inside, fanning herself, as she watches a heat advisory on TV. Behind her, the sun’s rays glow through the window and suffuse the room with heat.

This comic was written and illustrated by Connie Hanzhang Jin, based on reporting by Maria Godoy. It was edited by Carmel Wroth and Alyson Hurt.

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