Why heat may be the biggest health-related concern at the World Cup

(ABC) — As the World Cup gets underway in the United States, public health officials and researchers are surveilling for signs of infectious diseases, sexually transmitted infections, food-borne illnesses and other pathogens.

But health departments in host cities say something else could be the biggest health-related risk to teams, players or fans: Heat.

Extreme heat is the deadliest weather-related hazard in the U.S., claiming roughly 2,000 lives each year, according to data from the Centers for Disease Control and Prevention (CDC).

“We’ve really said from the beginning of the planning that our biggest concerns here in Philadelphia from a public health perspective during FIFA events is really sort of our bread-and-butter public health concerns, has been heat, has been air quality because those are things that really affect everyone,” James Garrow, communications director of Philadelphia’s Department of Public Health, told ABC News.

“There are folks who were worried about Ebola or hantavirus,” he continued. “Those are obviously concerning, but we thought the chances of them happening here are much lower.”

What health departments are doing to prepare

Eleven cities in the U.S. are hosting matches for the World Cup. Among them is Dallas, which is hosting nine matches — including a semi-final match on July 14.

The National Weather Service has issued a heat advisory from 12 p.m. CT to 9 p.m. CT on Thursday for north and central Texas, including Dallas, with heat index values of up to 110 degrees F. Dallas sees temperatures in the mid-to-high 80s and low 90s in July, according to NWS data.

“Heat-related illness is probably one of the most likely things with a high impact on a lot of people, people coming from all over the world that maybe aren’t used to the Texas heat,” Dr. Phil Huang, director of Dallas County Health and Human Services, told ABC News.

Huang said the department started planning more than a year and a half ago on how to keep players and spectators safe.

He and other public health department leaders said the messaging has been the most important aspect, sharing the importance of staying hydrated, staying in air-conditioned areas if possible and wearing a hat or sunscreen.

“We’re getting the messaging out, and these are messages that we get out every season … so we’re trying to get those messages out to everyone, especially people who just aren’t used to the Texas heat who may underestimate what sort of impact it could have,” Huang said.

Health departments across the country are also setting up cooling centers and water bottle refill stations.

Dr. Nichole Quick, chief science officer for the department of public health for Los Angeles County, told ABC News that when heat advisories and heat alerts go out county-wide, additional cooling centers are opened.

Garrow said nearly 100 cooling centers have been set up throughout Philadelphia and the department has set up a hotline with the Philadelphia Corporation for Aging for people to call in if they have questions about the heat or ways to keep cool.

“Our [FIFA] Fan Festival is just outside of downtown, but the main thoroughfare that people will walk and take to get out there, we’ve stationed five different hospitality hubs, which have shade and have misting stations and fans and places to refill water bottles,” he said. “And then at the Fan Festival, we have two huge tents set up that have fans in them and misting stations, picnic benches that are set up strategically in shaded areas.”

“And then throughout the rest of the venue as well, more fans, more misting stations, more water refilling stations,” he added. “Just in the interest of making it as easy and as available as possible to not only get access to water, but to get out of the sun and help cool yourself off.”

Departments are also partnering up with first responders and hospitals to make sure they can prepare to care for anyone suffering from heat-related illness. They have also launched tools to track illnesses in real time.

Dallas has a heat-related illness dashboard tracking heat exhaustion, heat cramps and heat stroke and other illnesses by date, age and gender.

Los Angeles County also launched a heat dashboard on weekly data on heat-related emergency room visits and deaths.

How heat can impact the body

Typically, during extreme heat — meaning temperatures are hotter or more humid than average — the body tries to cool itself by sweating.

Not replenishing with fluids can lead to dehydration. One’s body temperature can continue to rise, which can lead to other heat-related illnesses.

People may experience a sunburn, a heat rash or heat cramps, with signs including muscle pain and spasms.

More severe effects include heat exhaustion or heat stroke, a life-threatening condition when the body’s temperature rises above 104 degrees F and cooling mechanisms fail.Symptoms include neurological changes like confusion, slurred speech, loss of consciousness, and seizures.

Research has shown that extreme heat can also impact mental health.

A 2021 study from State University of New York at Buffalo and Yale School of Public Health found an association between short-term exposure to extreme heat and increased ER visits for mental health disorders.

“Heat really is one of those weather-related events and climate-related events that can affect anyone,” Quick, from the Los Angeles department of public health, said. “So even healthy folks — if they’re outside in heat for an extended period of time, for individuals that are outside exerting themselves — heat really can affect anyone And that’s why it is one of those that we rake a lot of time to educate everyone on and want folks to take precautions for heat preparedness whenever there is weather that could potentially create a heat risk.”