More Americans Dying From Hypothermia, CDC Says

Doctor offers tips to avoid dangerous drops in body temperatures during cold winter months

Thursday, February 19, 2015

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THURSDAY, Feb. 19, 2015 (HealthDay News) -- More people are dying from hypothermia in the United States, a new government report shows, raising fresh worries for a nation that has been pounded by a steady succession of winter storms this year.

Those most at risk for hypothermia include seniors, the mentally ill, people addicted to alcohol or drugs, and those living alone, according to the analysis published Feb. 20 in Morbidity and Mortality Weekly Report, a publication of the U.S. Centers for Disease Control and Prevention. Hypothermia is a dangerous drop in body temperature.

Local agencies have gotten better at responding to extreme cold emergencies by opening public warming shelters and taking other measures, but the CDC researchers concluded that more needs to be done.

"This report suggests that state and local health agencies also might need to focus more on public education, communication networks to reach the most vulnerable persons, and targeted interventions for groups at risk," the authors wrote.

More than 13,400 hypothermia deaths occurred in the United States between 2003 and 2013, with unadjusted annual rates ranging from 0.3 to 0.5 per 100,000 persons, the report says. A statistically significant increase in death rates from hypothermia occurred over the decade.

"There's a recurrent problem every year, and it always happens during these cold snaps where there are multiple days in a row in which the temperature drops below freezing," said Dr. Vaishali Patel, an assistant professor of emergency medicine at the Icahn School of Medicine at Mount Sinai, in New York City.

Men and women aged 65 or older are at much greater risk of hypothermia death. Average death rates for male seniors were 1.8 per 100,000 people during the decade in question, while female seniors had a 1.1 per 100,000 people hypothermia death rate, the report found.

"Elderly patients are at higher risk just due to their age and their slightly decreased circulation," Patel said, adding that some medications affect seniors' ability to regulate their body temperature. This means they can experience hypothermia more rapidly.

To better understand the risk factors for hypothermia, the Wisconsin Division of Public Health in 2014 began active surveillance for extreme-cold deaths, the CDC report said.

Between January 2014 and April 2014, there were 27 hypothermia-related deaths in Wisconsin. The CDC report noted several specific cases, including:

A 59-year-old woman was found in her driveway in February 2014, three days after her last contact with a friend. She lived alone and had several chronic illnesses, including type 2 diabetes, chronic obstructive pulmonary disease, and pinched spinal nerves. Investigators concluded that she fell down, hurt herself and froze to death, even though she had on weather-appropriate clothing.
A man with advanced Parkinson's disease, age 63, was found in a snow-covered field in March 2014. He lived alone, and family members reported that he had been unable to care for himself completely. Neighbors noted he had a tendency to wander outdoors. He was found wearing only jeans, a short-sleeved shirt, shoes and gloves.
A 25-year-old man was found frozen to death a block from his home. He had a history of being healthy, with no known medical conditions, but his blood alcohol level was nearly three times the legal limit.

Two-thirds of the people who died of hypothermia in Wisconsin were men, and their average age was 66, the report said. About one in five were intoxicated, subsequent toxicology tests determined. The average outdoors temperature at the estimated time of death was 6 degrees Fahrenheit, public health officials found.

People spending time outdoors during a cold snap should be aware of the symptoms of hypothermia, Patel said. These include confusion or sleepiness, slowed or slurred speech, shallow breathing, weak pulse, slow reactions and poor control over body movements.

"As hypothermia worsens, it starts to cause confusion and slows reaction times. The best thing is to try to catch it as early as possible," she said.

To avoid hypothermia, people should wear multiple layers of clothing, including a good head covering. "That's a prime place where heat is lost," Patel said.

People should limit the time they spend outdoors, and come inside to warm up as frequently as possible, she said. Unfortunately, many homeless people don't have access to warming shelters, particularly at night.

"Those centers are frequently overwhelmed with the number of people who are trying to get in, which leaves the homeless without anywhere to go to protect themselves," Patel said.

People should try to check in regularly with friends and relatives who are elderly, mentally impaired or struggling with an addiction, to make sure they are staying warm, Patel added.

"Make sure their heat is actually working," she said. "A lot of time, these deaths are caused by faulty heating systems. Check on them once a day, once every other day to make sure they are maintaining themselves and are not in a dangerous situation."

SOURCES: Vaishali Patel, M.D., assistant professor, emergency medicine, Icahn School of Medicine at Mount Sinai, New York City; Feb. 20, 2015, Morbidity and Mortality Weekly Report

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