Vulnerable groups exposed to elevated heat in waiting rooms
South Africa | Research conducted in eight rural primary health care (PHC) facilities in the Limpopo Province of South Africa revealed that indoor temperatures in waiting rooms when compared to ambient (outdoor) temperatures were higher by 2 – 4ºC on average. Temperature loggers used over a six month period at times recorded a daily indoor temperature that regularly exceeded 38ºC.
“The health care delivery environment inevitably becomes strenuous for all health care workers and patients waiting on care are at risk of potential heat-health related symptoms,” says lead author and Senior Specialist Scientist at the South African Medical Research Council’s (SAMRC) Environment & Health Research Unit, Dr Caradee Wright.
Model projections for temperature in a changing climate, according to the literature, also predict elevated temperatures and more frequent heat waves, both of which may impact adversely on human health. In several countries around the world, including South Africa, a substantial portion of the country’s population relies on government-funded health care systems and infrastructure, including hospitals and clinics. A study describing 78 PHC clinics in KwaZulu-Natal (South Africa) revealed that 30 (59%) clinics had ceiling fans, and 18 (35%) had air conditioners that only provided temperature control1.
The National Core Standards for Health Establishments in South Africa stipulates that appropriate ventilation must be provided in theatres, patient accommodation and waiting areas. This stipulation has been left open to interpretation as “appropriate ventilation” is not clearly defined and as a result PHC centres and clinics are characterised by varying resources and infrastructure. Inadequate resourcing and poor infrastructure at PHC centres and clinics, coupled with findings in a study conducted in a South African district hospital revealing that stable patients have a 545 min (9 hour) waiting time, is a recipe that exposes vulnerable groups to elevated temperatures and climate-related health threats.
The SAMRC study alludes to the fact that individuals in clinic waiting rooms may have underlying conditions which predispose them to infection and can be exposed to individuals who may be shedding potentially pathogenic microorganisms. The situation may be compounded by increased temperatures considering that changes in infectious disease transmission patterns are a likely major consequence of climate change.
It is imperative that Health Authorities conduct clinic temperature assessments and implement client and staff-related strategies to reduce heat related hazards or ill health associated with clinic visits. Those actions must be coupled with a continued awareness by health care workers to monitor heat-related health symptoms which include headaches, nausea as well as heat stroke and cardiac arrest in extreme cases. Research has shown that older groups, children and those with pre-existing diseases are at particular risk.