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Coping with extremely hot, humid weather

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• Condition Could Lead To Kidney Failure, Stroke, Excessive Bleeding, Other Renal Ailments
• Experts Recommend Reducing Exposure To Sun, Drinking Plenty Of Water Daily

“The weather is hot. I can hardly sleep at night because I sweat profusely leaving my bed and pillow so wet. I have to wake up about two times in the night to take my bath. It is no any better in the day, because I am always drenched in sweat.”

These are some of the complaints of most Nigerians due to the current hot and humid weather nationwide, even in coastal areas, such as Lagos.

Indeed, the situation is causing concern across the country as meteorologists and medical experts warn of its dangers on human and natural resources.

From an average temperature of 33 degree Celsius and 70 per cent humidity in Lagos to 39 degree Celsius and 11 per cent in Maiduguri, the excessive sweating and heath rashes have become regular these days, making it difficult for many, especially children, to sleep comfortably at night.

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Medical experts warn that the extreme weather could lead to more dire consequences, such as kidney failure, stroke, excessive bleeding and skin cancer in Albinos.

On their part, scientists blame the situation on increased Ultra Violet (UV) rays caused by the depletion of the ozone layer, warning that this could sterilise trees.

But to the meteorologists, the hot weather is a normal phenomenon around this period of the year due to transition from dry to rainy season.

According to a research review, an increase in heat waves worldwide linked to climate change might be behind the epidemics of kidney disease detected in workers, who are increasingly exposed to heat and dehydration.

A Consultant Public Health Physician at the Lagos University Teaching Hospital (LUTH), Idi-Araba, Prof Akin Osibogun, had told The Guardian: “When the weather is persistently hot and humid, as being experienced now, what happens is that there will be heat exhaustion and dehydration.

“When this loss of bodily fluid continues without adequate replacement, it will affect the body organs, especially the kidney that is involved with ultra-filtration. This can lead to kidney failure. Rapid water loss causes the kidney’s functioning to slow down, resulting in temporary or permanent kidney failure.

“Extreme heat causes rapid water loss, resulting in acute electrolyte imbalance. The kidney, unable to cope with the water loss, fails to flush out the requisite amount of creatinine and other toxins from the body. Coupled with a lack of consistent water intake, this brings about permanent or temporary kidney failure.”

He continued: “Another thing that can happen under this kind of hot and humid weather is that it will affect the brain and blood. It makes the blood less viscous and can easily escape from the vessels, causing excessive bleeding and haemorrhagic stroke.

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“It can also cause skin cancer, but only in Abinos. People with black (dark) skin are protected from the carcinogenic effect of direct ultra-violet rays from the sun, because their skins have melanin. In most cases, they develop rashes, which can be very discomforting.”

Previous study published in Asian Journal of Pharmaceutical and Clinical Research found that burden of renal diseases might increase, as the period of hot weather becomes more frequent, and this is further aggravated in advanced age and people with chronic diseases, such as diabetes and hypertension.

Another study published in the Clinical Journal of the American Society of Nephrology noted that extreme heat exposure could have immediate health effects, causing dehydration, heat exhaustion and heat stroke, as well as worsening pre-existing chronic disease, which can be fatal.

The researchers said although chronic kidney disease is often caused by diabetes or high blood pressure, it could also be the result of recurrent heat exposure with physical activity and not enough hydration, which puts a heavy strain on the kidneys.

Meanwhile, new research has shown people really do get hot and bothered in warm weather. A study has found stress hormones rise in tandem with the thermometer.

The discovery sheds fresh light on a phenomenon that has puzzled scientists for years.

Dubbed the ‘summertime blues’ there is a wealth of evidence from the past few decades linking heat exposure to aggression, suicide and violence.

Now a Polish team has found this all boils down to the fact that levels of the stress hormone cortisol are lower in winter than summer, and the heat-driven rise makes us tetchy.

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It could have implications for public health because the chemical is vital to regulating sugar, salt and fluids throughout the body.

The report was first published in DailyMailUK Online.

Dr. Dominika Kanikowska, a pathophysiologist at Poznan University of Medical Sciences, said having more circulating when it is warm was a surprise.

She said: “These non-intuitive findings contradict traditional concepts of the taxing physical toll of winter and the relaxed ease of summer.”

The original data that first associated heat with hostility came from crime statistics. Analyses noted those involving violence increased in summer – especially when it was warmer than average.

Numerous theories have been suggested including raised temperatures causing an increase in heart rate, testosterone and other metabolic reactions that trigger the sympathetic nervous system.

This is responsible for the fight-or-flight response – so people are more inclined to fight.

Kanikowska and colleagues say the reason is simple: it all boils down to the effect of the weather on cortisol.

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It is referred to as the ‘stress hormone’ because it is released into the bloodstream during difficult or upsetting situations.

Kanikowska said: “The hormone helps reduce inflammation and is essential for maintaining overall health.

“Cortisol levels are typically highest in the morning and gradually drop throughout the day. Levels are lower in the evening to maintain healthy sleeping patterns.

“Illness, lack of sleep and certain medications can affect cortisol levels more than normal daily fluctuations.”

Her researchers studied a group of female medical students on two separate days in both winter and summer. They found cortisol levels to be higher on the latter dates. Inflammation levels did not change significantly between seasons.

Kanikowska said there have been studies into the seasonal variability of the hormone but these have shown inconsistent results.

This is possibly because participants were tested in their own homes and not in a uniform setting.

She said her study presented at an American Physiological Society meeting in San Diego was the most thorough of its kind.

They took saliva samples every two hours during each testing period – a full 24-hour cycle – to measure levels of cortisol and markers of inflammation.

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The volunteers also completed a lifestyle questionnaire during each session about their sleep schedule, diet and physical activity levels.

Also, a new research suggests that drinking sugary, caffeinated soft drinks while exercising in hot weather may increase the risk of kidney disease. The study is published ahead of print in the American Journal of Physiology—Regulatory, Integrative and Comparative Physiology.

A research team from the University at Buffalo in New York studied healthy adults in a laboratory environment that mimicked working at an agricultural site on a hot day (95 degrees Fahrenheit). The volunteers completed an hour-long exercise cycle consisting of a 30-minute treadmill workout followed by three different five-minute lifting, dexterity and sledgehammer swinging activities. After 45 minutes of exercise, the volunteers rested for 15 minutes in the same room while drinking 16 ounces of either a high-fructose, caffeinated soft drink or water. After the break, they repeated the cycle three more times for a total of four hours. Before leaving the laboratory, the volunteers were given more of their assigned beverage to drink before consuming any further fluids. The volume was either 1 liter or a volume equal to 115 percent of their body weight lost through sweating, if that amount was greater. The researchers measured the participants’ core body temperature, heart rate, blood pressure, body weight and markers of kidney injury before, immediately after and 24 hours after each trial. All volunteers participated in both soft drink and water trials separated by at least seven days.

The research team found higher levels of creatinine in the blood and a lower glomerular filtration rate—markers for kidney injury—after the soft drink trial. These temporary changes did not occur when the participants drank water. In addition, the participants’ blood levels of vasopressin, an anti-diuretic hormone that raises blood pressure, was higher and they were mildly dehydrated during and after the soft drink trial. “The consumption of soft drinks during and following exercise in the heat does not rehydrate,” the researchers explained. “Thus, consuming soft drinks as a rehydration beverage during exercise in the heat may not be ideal. Further work will need to discern the long-term effects of soft drink consumption during exercise in the heat, and its relation to the risk of kidney disease.”

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Also, according to a study titled “Investigating Effects of Climate Change on Health Risks in Nigeria” and published in ONLINE FIRST by Ilevbare Femi, cerebra-spinal meningitis is one of the infectious diseases likely to be caused by climate change. Incidences of meningitis, for instance, have been on the rise in Nigeria due to excessive heat. According to Akingbade, cases of meningitis have been reported to increase in Nigeria as a result of excessive heat.

Meningitis is a disease caused by an infection due to bacteria, viruses and protozoa, of the meanings, which is the thin lining that surrounds the brain and the spinal cord.

The results of another study suggest future temperature increases due to climate change have the potential to significantly increase meningitis cases in both the early (2020–2035) and late (2060–2075) twenty-first century, and for the seasonal onset of meningitis to begin about a month earlier on average by late century, in October rather than November.

Also, climatic conditions have been shown to affect water-borne diseases in Nigeria. The changes in climatic conditions are germane to lengthen the transmission seasons of important vector-borne diseases and alter their geographic range. Malaria has been identified to be caused by climate conditions due to unicellular organism known as Plasmodium and transmitted by the bite of infected female Anopheles mosquitoes. Evidence shows that malaria accounted for over 45 per cent of all outpatients and about 50 per cent of the Nigerians suffer from at least one episode of malaria each year.

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Scholars have argued that global warming, a consequence of climate change, could be linked—directly or indirectly—to the persistence as well as the re-emergence of malaria epidemics. The association between climate change and malaria spread is complex and remains a subject of controversy and debates. Therefore, Adewuyi and Adefemi posited that the spread and severity of malaria in several places and the increased incidences of the disease in some regions could indeed be associated with the effects and consequences of climate change. With this assertion, Adewuyi and Adefemi suggest that the biology of the Plasmodium spp, the ecology of mosquitoes and even the susceptibility of humans to malaria could all be affected directly/indirectly by extreme climatic events.

In Nigeria, evidence suggests an estimated 137,600 diarrhoeal deaths in children under-15 years of age in the baseline period of 2008. Furthermore, it was reported that under a high emissions event, diarrhoeal deaths which are linked to climate change in children under 15 years of age are projected to be 9.8 per cent of the over 76,000 diarrhoeal deaths predicted in 2030.

Evidence has proven that climate change has environmental and economic consequences on human health. The effects on human diseases such as skin cancer have been relatively under-emphasised. There is a direct link between ultraviolet (UV) exposure from the sun and the development of malignant skin disease.

One profound effect of climate change is among the aged persons in Nigeria. According to Aina and Adewoyin, the vulnerable age are particularly more at risk of climate-related diseases because of the effect of their age on their physiological and immunological compositions. Research has provided credence that the aged are more at risk of climate-related diseases because they have a lower physiological reserve, possess a slower rate of metabolism and a weakened immune system and have a higher morbidity rate.

Solutions
On what Nigerians should do to protect themselves, Osibogun, who is the immediate past Chief Dedical director (CMD) of LUTH, said: “We should reduce our exposure to the sun. It depends on the kind of work you do, but reduce the number of hours you stay under the sun, or rather outside, although some people, like bricklayers, cannot help but stay in the sun all day.

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“The negative effect could also be reduced by drinking enough water to replace the lost fluid from excessive sweating. Try and carry bottled water wherever you go and drink at least three litres of water daily.”

A consultant meteorologist, Mr. Cyprian Okoloye, formerly with the Central Forecast Office of the Nigeria Meteorological Agency (NIMET), noted: “The weather is not unusual. We are approaching the transition period between the dry season and rainy season. Usually, during the transition period, you experience very hot and humid weather. In a couple of days, you may see some showers.

“The situation will return after the showers, even harsher conditions.”

According to the United States Centers for Disease Control and Prevention (CDC), people at greatest risk for heat-related illness can take the following protective actions to prevent illness or death:
*Stay in air-conditioned buildings as much as you can. Contact your local health department or locate an air-conditioned shelter in your area. Air-conditioning is the number one way to protect yourself against heat-related illness and death. If your home is not air-conditioned, reduce your risk for heat-related illness by spending time in public facilities that are air-conditioned and using air conditioning in vehicles.
*Do not rely on a fan as your main cooling device during an extreme heat event.
*Drink more water than usual and don’t wait until you’re thirsty to drink.
*Check on a friend or neighbor and have someone do the same for you.
*Don’t use the stove or oven to cook—it will make you and your house hotter.

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Even young and healthy people can get sick from the heat if they participate in strenuous physical activities during hot weather:
*Limit your outdoor activity, especially midday when the sun is hottest.
*Wear and reapply sunscreen as indicated on the package.
*Pace your activity. Start activities slow and pick up the pace gradually.
*Drink more water than usual and don’t wait until you’re thirsty to drink more. *Muscle cramping may be an early sign of heat-related illness.
*Wear loose, lightweight, light-colored clothing.

If you play a sport that practices during hot weather, protect yourself and look out for your teammates:
*Schedule workouts and practices earlier or later in the day when the temperature is cooler.
*Monitor a teammate’s condition, and have someone do the same for you.
*Seek medical care right away if you or a teammate has symptoms of heat-related illness.

Everyone should take these steps to prevent heat-related illnesses, injuries, and death during hot weather:
*Stay in an air-conditioned indoor location as much as you can.
*Drink plenty of fluids even if you don’t feel thirsty.
*Schedule outdoor activities carefully.
*Wear loose, lightweight, light-colored clothing and sunscreen.
*Pace yourself.
*Take cool showers or baths to cool down.
*Check on a friend or neighbour and have someone do the same for you.
*Never leave children or pets in cars.
*Check the local news for health and safety updates.

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