Associated Press SAN ANTONIO — The father of a 13-year-old boy found dead the morning after his first football practice at a Texas middle school said Monday that he thinks his son might still be alive had the team not been playing in sweltering triple-digit heat.

Brent Shinn McGhee did not wake up Aug. 25, the morning after Vernon Middle School held its first practice. Temperatures in the rural north Texas area climbed as high as 105 degrees, according to the National Weather Service.

Brock McGhee said his son had epilepsy and took medication for his condition, but believes the death was partly related to the heat. The official cause of death has not been determined, and it will likely be weeks before a final autopsy is complete.

“Putting kids through this to win a football game. It makes no sense,” Brock McGhee said. But he added that he did not blame his son’s coaches.

Tom Woody, superintendent of the Vernon Independent School District, said he didn’t think it was too hot to hold practice and defended his coaches and school policies. He said players had plenty of access to water and were supervised closely.

“I think we had the safeguards in place that were appropriate,” Woody said.

Scrutiny over protecting athletes from heat-related illnesses, while always an issue at the start of each football season, has intensified over the past year.

In Kentucky, a football coach went on trial Monday charged with reckless homicide in the death of a 15-year-old who collapsed during practice last August and died three days later.

Heat illness got more attention this summer when the National Athletic Trainers’ Association released a set of recommendations on how coaches should acclimate players to the heat. Among them were no two-a-day practices the first week for high school teams.

Woody said the middle school practiced for about 1 ½ hours the first day; Brock McGhee said it was closer to two hours. Details of the practice were muddled, but players worked out while wearing a helmet and shirts and shorts. They did not wear any other padding.

Brock McGhee, 30, said his son looked red and was thirsty after his mother picked him up from practice. But aside from telling his dad that practice was hard, Brock McGhee said his son gave him no indication that he was having health problems.

The next morning, McGhee went to wake up his son for school and found him unresponsive. He was rushed to a hospital and later pronounced dead.

Brock McGhee said he didn’t know if coaches knew his son was epileptic. Woody said the school had records noting Brent’s epilepsy but was unsure whether the coaches did, too.

Seizures can happen at any time and are unpredictable, said Dr.  Paul Van Ness, a neurologist at the University of Texas Southwestern Medical Center in Dallas. He said stresses, like heat, can trigger seizures in some people. But he also said a person who was overheated would be likely to show symptoms.

Woody said the school had no policies to adjust practice based on the temperature. He said the school made no changes to how practices are conducted after Brent’s death, and noted the temperatures have dropped since the first week of practice.

Vernon, a town of about 11,000 people, is about 200 miles northwest of Dallas.

By Anne Marie Helmenstine, Ph.D., About.com

See More About:

• science faqs
• how things work
• water chemistry
• water intoxication

Question: Can You Drink Too Much Water?

Answer: You’ve probably heard that it’s important to ‘drink plenty of fluids’ or simply ‘drink lots of water’. There are excellent reasons for drinking water, but have you ever wondered if it’s possible to drink too much water. Here’s what you need to know:

Can You Really Drink Too Much Water?

In a word, yes. Drinking too much water can lead to a condition known as water intoxication and to a related problem resulting from the dilution of sodium in the body, hyponatremia. Water intoxication is most commonly seen in infants under six months of age and sometimes in athletes. A baby can get water intoxication as a result of drinking several bottles of water a day or from drinking infant formula that has been diluted too much. Athletes can also suffer from water intoxication. Athletes sweat heavily, losing both water and electrolytes. Water intoxication and hyponatremia result when a dehydrated person drinks too much water without the accompanying electrolytes.

 What Happens During Water Intoxication?

When too much water enters the body’s cells, the tissues swell with the excess fluid. Your cells maintain a specific concentration gradient, so excess water outside the cells (the serum) draws sodium from within the cells out into the serum in an attempt to re-establish the necessary concentration. As more water accumulates, the serum sodium concentration drops — a condition known as hyponatremia. The other way cells try to regain the electrolyte balance is for water outside the cells to rush into the cells via osmosis. The movement of water across a semipermeable membrane from higher to lower concentration is called osmosis. Although electrolytes are more concentrated inside the cells than outside, the water outside the cells is ‘more concentrated’ or ‘less dilute’ since it contains fewer electrolytes. Both electrolytes and water move across the cell membrane in an effort to balance concentration. Theoretically, cells could swell to the point of bursting.

From the cell’s point of view, water intoxication produces the same effects as would result from drowning in fresh water. Electrolyte imbalance and tissue swelling can cause an irregular heartbeat, allow fluid to enter the lungs, and may cause fluttering eyelids. Swelling puts pressure on the brain and nerves, which can cause behaviors resembling alcohol intoxication. Swelling of brain tissues can cause seizures, coma and ultimately death unless water intake is restricted and a hypertonic saline (salt) solution is administered. If treatment is given before tissue swelling causes too much cellular damage, then a complete recovery can be expected within a few days.

It’s Not How Much You Drink, It’s How Fast You Drink It!

The kidneys of a healthy adult can process fifteen liters of water a day! You are unlikely to suffer from water intoxication, even if you drink a lot of water, as long as you drink over time as opposed to intaking an enormous volume at one time. As a general guideline, most adults need about three quarts of fluid each day. Much of that water comes from food, so 8-12 eight ounce glasses a day is a common recommended intake. You may need more water if the weather is very warm or very dry, if you are exercising, or if you are taking certain medications. The bottom line is this: it’s possible to drink too much water, but unless you are running a marathon or an infant, water intoxication is a very uncommon condition.

By badbadivy

Tennessee and many other areas are going through a massive heat wave right now. Some people have to deal with this heat without air conditioning. Here’s a guide to getting through the heat wave without air conditioning.

• Make a swamp cooler.  Blow a fan over a pan of ice. Seriously, it’s just that easy, and it makes a major difference in the temp. Change the ice out when it melts.
• Fans, fans everywhere. When my air conditioning decided to break during a Tennessee heat wave, I went out and bought a crapload of fans. I made swamp coolers out of many of them, then I used the others to blow the cooled air around the house. I turned all my ceiling fans on as well- make sure they are on the “summer” setting, blowing downward.
• Windows closed during the day, open at night. Try to get them closed before the sun comes up and starts to heat up the air outside.
• Close your curtains during the day. You want to try to block as much of the sun out as possible. It heats your house up to have the sun shining in.
• Stay on the lowest level of your home. Heat rises, so it stands to reason that you should stay on the lowest level of your home. If you have a basement, it’s the coolest place to be.
• Sleep nekkid. Well, if you *can*, anyway. Spray the sheets so they are slightly damp before you lay down and get a wet washcloth for your forehead. Then turn on the fan and get some sleep.
• Take a tepid bath. Not cold, not hot. Tepid.
• Make sure you and your pets have plenty of water. You’re gonna lose a lot of water, sweating so much, so make sure you are properly hydrated.
• Stand and stare in your refrigerator. Okay, not the best idea for long-term, but if you just can’t take it, have a few cool moments with your refrigerator or freezer.
• Don’t use “hot” appliances. Think about it- your stove, oven, dishwasher, and dryer all heat up your house. This is great in the fall when you’re trying to put off turning the heat on for another couple of days, but it’s not a good idea in the summer when it’s miserably hot. Wait until darkness falls if you need to use one of those appliances. But washing your dishes by hand might actually cool you down a bit, so consider that.
• Popsicles are your friends! Stock up on ‘em.
• If all else fails, go somewhere with air conditioning. Like your mom’s house, or the mall, or the library. 

Heat Stress in the Workplace

Heat stress includes a series of conditions where the body is under stress from overheating. It can include heat cramps, heat exhaustion, heat rash or heat stroke. Each produces bodily symptoms that can range from profuse sweating to dizziness to cessation of sweating and collapse. Heat stress can be induced by high temperatures, heavy work loads, the type of clothing being worn, etc.

It is important to know the signs of heat stress and the proper first aid to treat it.

The signs of heat stress are often overlooked by the victim. The employee may at first be confused or unable to concentrate, followed by more severe symptoms such as fainting and/or collapse. If heat stress symptoms occur, move the employee to a cool, shaded area, give him/her water and immediately contact the supervisor.

At-risk Employees

Some employees are more likely to have heat disorders than others. Younger employees and those more physically fit are often less likely to have problems. Employees with heart, lung or kidney disease, diabetes and those on medications are more likely to experience heat stress problems. Diet pills, sedatives, tranquilizers, caffeinated drinks and excessive alcohol consumption can all exacerbate heat stress effects.

It often takes two to three weeks for employees to become acclimated to a hot environment. This acclimation can subsequently be lost in only a few days away from the heat. Thus employees should be more cautious about heat stress after coming back from a vacation, when beginning a new job, or after the season’s first heat wave. In short, precautions should be taken anytime there are elevated temperatures (approaching 90 degrees F) and the job is physically demanding.

Other Factors

Other heat stress factors are also very important. In addition to temperature, increased relative humidity, decreased air movement or lack of shading from direct heat (radiant temperature) will all affect the potential for heat stress.

Prevention of Heat Stress - Supervisors:

• Allow time for employees to adjust to hot jobs when possible. It often takes two to three weeks for an employee to become acclimated to a hot environment.
• Adjust the work schedule, if possible. Assign heavier work on cooler days or during the cooler part of the day.
• Reduce the workload. Increase the use of equipment on hot days to reduce physical labor.
• Establish a schedule for work and rest periods during hot days.
• Train workers to recognize signs and symptoms of heat stress disorders and be prepared to give first aid if necessary.
• Choose appropriate employees. Avoid placing “high risk” employees in hot work environments for extended time periods. Realize individual employees vary in their tolerance to heat stress conditions.

Prevention of Heat Stress - Workers:

• Learn to recognize the symptoms of heat stress. Pace the work, taking adequate rest periods (in shade or cooler environment).
• Use adequate fans for ventilation and cooling, especially when wearing personal protective equipment (PPE).
• Wear light colored, loose (unless working around equipment with moving parts) clothing.
• Keep shaded from direct heat where possible (e.g., wear a hat in direct sunshine).
• Drink plenty of water. In hot environments the body requires more water than it takes to satisfy thirst.

2809 Daley Drive - Ames, IA 50011-3660 - (515) 294-5359
Copyright © 2005, Iowa State University, all rights reserved.

It’s been a long and hot summer. The Heat Aware card has proven to be a great visual tool for showing people just how hot it is, with the ambient temp. displayed on the liquid crystal thermometer .

Heat-related Illnesses
???? Know that heat exhaustion and other heat-related illnesses can occur even when the outside temperature isn’t extremely high. Use the National Weather Service’s heat index (which combines air temperature and relative humidity) to tell you how hot it actually feels. *
???? Drink small amounts of water every 20 to 30 minutes when the threat of heat illness is high. Avoid coffee, other drinks with caffeine, and alcohol, which increase your risk of heat illness.
???? Be sure you and your workers are acclimatized to working in the heat. Know that persons who are over 40, overweight, in poor physical condition, or have a past history of heat illness are often more sensitive to the heat.
???? Choose the coolest possible personal protective equipment (PPE) when applying pesticides or other chemicals in hot, humid conditions. Read the product label for the minimum amount of PPE that’s required.
???? Wear light-colored, loose-fitting clothing that reflects the heat and allows your body to release heat. Materials such as cotton or cotton/polyester blends “breathe” and allow air circulation.
???? Take sufficient breaks out of the sun when the heat index is high. Also, try to schedule your most strenuous tasks early in the morning or later in the day.
???? Train your workers to recognize the signs of heat-related illnesses, and to respond appropriately. Know that heat stroke – characterized by excessively high body temperature, confusion, irrational behavior, slowed down or no sweating, rapid breathing and pulse (if conscious), and possible convulsions – can occur suddenly and is a life-threatening medical emergency. Call 911 immediately if heat stroke is suspected.
???? Know that the symptoms of heat exhaustion and organophosphate (OP) poisoning are very similar, but their treatments are very different. Call 911 if you suspect either but are uncertain.

Heat stroke occurs when the body’s system of temperature regulation fails and body temperature rises to critical
levels. This condition is caused by a combination of highly variable factors, and its occurrence is difficult
to predict. Heat stroke is a medical emergency. The primary signs and symptoms of heat stroke are confusion;
irrational behavior; loss of consciousness; convulsions; a lack of sweating (usually); hot, dry skin; and an
abnormally high body temperature, e.g., a rectal temperature of 41°C (105.8°F). If body temperature is too
high, it causes death. The elevated metabolic temperatures caused by a combination of work load and environmental
heat load, both of which contribute to heat stroke, are also highly variable and difficult to predict.
If a worker shows signs of possible heat stroke, professional medical treatment should be obtained immediately.
The worker should be placed in a shady area and the outer clothing should be removed. The worker’s
skin should be wetted and air movement around the worker should be increased to improve evaporative cooling
until professional methods of cooling are initiated and the seriousness of the condition can be assessed.
Fluids should be replaced as soon as possible. The medical outcome of an episode of heat stroke depends on
the victim’s physical fitness and the timing and effectiveness of first aid treatment. Regardless of the worker’s
protests, no employee suspected of being ill from heat stroke should be sent home or left unattended unless a
physician has specifically approved such an order.
The signs and symptoms of heat exhaustion are headache, nausea, vertigo, weakness, thirst, and giddiness.
Fortunately, this condition responds readily to prompt treatment. Heat exhaustion should not be dismissed
lightly, however, for several reasons. One is that the fainting associated with heat exhaustion can be dangerous
because the victim may be operating machinery or controlling an operation that should not be left unattended;
moreover, the victim may be injured when he or she faints. Also, the signs and symptoms seen in heat
exhaustion are similar to those of heat stroke, a medical emergency.
Workers suffering from heat exhaustion should be removed from the hot environment and given fluid
replacement. They should also be encouraged to get adequate rest.
Performing hard physical labor in a hot environment usually causes heat cramps. These cramps have been
attributed to an electrolyte imbalance caused by sweating. It is important to understand that cramps can be
caused by both too much and too little salt. Cramps appear to be caused by the lack of water replenishment.
Because sweat is a hypotonic solution (±0.3% NaCl), excess salt can build up in the body if the water lost
through sweating is not replaced. Thirst cannot be relied on as a guide to the need for water; instead, water
must be taken every 15 to 20 minutes in hot environments.
Under extreme conditions, such as working for 6 to 8 hours in heavy protective gear, a loss of sodium may
occur. Recent studies have shown that drinking commercially available carbohydrate-electrolyte replacement
liquids is effective in minimizing physiological disturbances during recovery.
In heat collapse (fainting), the brain does not receive enough oxygen because blood pools in the extremities.
As a result, the exposed individual may lose consciousness. This reaction is similar to that of heat exhaustion
and does not affect the body’s heat balance. However, the onset of heat collapse is rapid and unpredictable. To
prevent heat collapse, the worker should gradually become acclimatized to the hot
environment.
Heat rashes are the most common problem in hot work environments. Prickly heat is manifested as red
papules and usually appears in areas where the clothing is restrictive. As sweating increases, these papules give
rise to a prickling sensation. Prickly heat occurs in skin that is persistently wetted by unevaporated sweat, and
heat rash papules may become infected if they are not treated. In most cases, heat rashes will disappear when
the affected individual returns to a cool environment.
A factor that predisposes an individual to heat fatigue
is lack of acclimatization. The use of a program of
acclimatization and training for work in hot environments
is advisable. The signs and symptoms of heat
fatigue include impaired performance of skilled sensorimotor,
mental, or vigilance jobs. There is no treatment
for heat fatigue except to remove the heat stress
before a more serious heat-related condition develops.

An effective heat stress program does not begin and end with measurements. Sound industrial hygiene practice
includes worker training and site-specific controls. All managers and workers working in the hot environments
need to be trained on the signs and symptoms of heat stress, how to recognize problems with
themselves and coworkers, how to prevent heat injuries, and what first aid should be administered.
General and job-specific controls can be implemented once the job demands and constraints are understood.
General controls may include: medical screening for fitness; acclimating workers to the heat; allowing selflimited
exposures; encouraging healthy diets and lifestyles; and providing cool water or electrolyte replacement
drinks to encourage frequent drinking. Job specific and engineering controls may include: limiting
exposure times; moving the most strenuous tasks to cooler times of the day; reducing workloads through the use of machinery and tools; using cooling vests; shielding the heat source or providing a sun shade; or
increasing the air flow using fans.

Why should companies be concerned with work to rest regimens when they haven’t had a heat stress related injury in a long time?

INTRODUCTION
At a conference on heat stress, a manager asks: “Why should I put efforts into a heat stress program when I
have not seen a single heat stress injury report over the past nine years?” When this manager was asked if he
looked for trends relating the number of accidents and injuries to
the heat, he admitted that he had not. Reflecting on this, the
manager began to show a deeper interest in the topic. Why? The
potential for accidents and injuries to occur as a result of
heat-induced disorders can represent a greater risk of loss than
the heat-induced disorder itself. A single worker experiencing a
heat-induced disorder can put the safety of an entire work crew,
plant or community at risk.
USER APPLICATION NEWS NOTE 4
HEALTH & OTHER RISKS
Heat tends to promote accidents due to dizziness, the slipperiness
of sweaty palms, or the fogging of safety glasses. Aside from these
more obvious dangers, the frequency of accidents, in general appears to be higher in hot environments than
in more moderate environmental conditions. One reason is that working in a hot environment lowers the
mental alertness and physical performance of an individual. Increased body temperature and physical
discomfort promote irritability, anger, and other emotional states, which sometimes cause workers to
overlook safety procedures or to divert attention from hazardous tasks. Heat stroke, exhaustion, cramps,
collapse, rashes and fatigue are all forms of heat-induced disorders that are either serious health risks
themselves or can lead to serious compromises in safety.
Work/Rest Regimens as a
Heat Stress Management Tool
RO OT CAUSES
Operations involving high air temperatures, radiant heat sources, high humidity, direct physical contact with
hot objects, or strenuous physical activities have a high potential for inducing heat stress in employees
engaged in such operations. Such places include: iron and steel foundries, nonferrous foundries, brick-firing
and ceramic plants, glass products facilities, rubber products factories, electrical utilities (particularly boiler
rooms), bakeries, confectioneries, commercial kitchens, laundries, food canneries, chemical plants, mining
sites, smelters, and steam tunnels.
Outdoor operations conducted in hot weather, such as construction, refining, asbestos removal, and hazardous
waste site activities, especially those that require workers to wear semi-permeable or impermeable protective
clothing, are also likely to cause heat stress among exposed workers.

Early in the spring, companies with employees that are exposed to the intense outdoor heat begin their awareness programs. Implementing proper hydration procedures is imperative when working in the heat.

Outdoor Action Guide to Heat-Related
Illnesses & Fluid Balance
by Rick Curtis - Outdoor Action Program, Princeton University

Heat injuries can be immediately life-threatening. Be aware of the temperature conditions and your hydration levels. The information provided here is designed for educational use only and is not a substitute for specific training or experience. Princeton University and the author assume no liability for any individual’s use of or reliance upon any material contained or referenced herein. This article is prepared to provide basic information about heat related illnesses for t e lay person. Medical research is always expanding our knowledge of the causes and treatment. It is your responsibility to learn the latest information. The material contained in this article may not be the most current. Copyright © 1997 Rick Curtis, Outdoor Action Program, Princeton University.

Fluid Balance

All the body’s fluids make up one large body fluid pool. Losses of fluid from any one source is reflected in the levels of all the body’s other fluids: e.g. profuse sweating will ultimately result in decreased blood volume. If a patient loses enough fluid through any manner-bleeding, sweating, vomiting, or diarrhea-the end result is the same: dehydration and, potentially, volume shock. Adequate fluid is also critically important in hot environments to help our body thermoregulate (see Heat llnesses page 00). Remember, dehydration can kill!

If someone is chronically losing fluid (from diarrhea or vomiting), then you have a real emergency on your hands. Treat the cause of the fluid lose as best you can (see Shock page 00, Bleeding page 00, Heat Illnesses page 00, Abdominal Infections page 00) and rehydrate the patient. Be prepared to evacuate your patient.

Dehydration is always easier to prevent than it is to treat. So it is important to ensure that all members of your group replace their regular fluid losses by drinking adequate amounts of water (see below). Your body absorbs fluids best when you drink frequently and in small amounts rather than drinking large amounts at one time. It also helps with fluid absorption if you drink while eating. A pinch of salt and sugar in the water will do if no food is available. Very dilute mixtures of ports drinks like Gatorade® (add just enough to taste) work well for this purpose.

Don’t depend on feeling thirsty to tell you when to drink. Thirst is a late response of the body to fluid depletion. Once you feel thirsty, you are already low on fluids. The best indicator of proper fluid levels is urine output and color. You, and all the people in your group should strive to be “copious and clear.” Ample urine that is light colored to clear shows that the body has plenty of fluid. Dark urine means that the body is low on water, and is trying to conserve its supply by hoar ing fluid which means that urine becomes more concentrated (thereby darker).