Fizala Khan
A thick blanket of snow covered Kashmir over the past week as most areas received heavy snowfall, Along with the heavy snow and avalanche warning came the news of four members of a family being hospitalized on Saturday morning after they lost consciousness in their sleep from asphyxiation at a village in South Kashmir’s Shopian district.
Asphyxiation from gas heaters:
As winter sets in Kashmir, people look for warmth. Some resort to either a traditional Hammam (Kashmiri Hammam is an improvisation of the Turkish bath) or alternatives like gas heaters. Gas heaters can cause asphyxiation, which is a condition of a deficient supply of oxygen to the body that arises from abnormal breathing. In an enclosed space, without any chimney or ventilation, these gas heaters can emit gases like carbon monoxide. It is extremely harmful and fatal if not treated.
These emissions result in high levels of carbon monoxide in an enclosed space and there is no possible way of detecting it, because of the odorless nature of the gas.
Carbon monoxide is termed a silent killer. It has no odor or taste, nor is it an irritant to the eye or nose, or skin. It is very difficult to detect it, except with a carbon sensor. The hemoglobin in our blood, which carries oxygen to the various cells, tissues, and organs, has a great affinity for carbon monoxide and as the concentration of carbon monoxide in the air increases, it displaces the oxygen in the hemoglobin, and without oxygen supply, the cells and tissues in the body begin to die. In a room with no fresh air coming in, slowly, the oxygen level in the room depletes, leading to incomplete combustion, thereby releasing carbon monoxide. If there is no outlet for the toxic air to escape, it builds up to an alarming extent inside the bedroom, and in most such cases, people who are sleeping and breathing that air will become unconscious and die, as there is very little consumer awareness about the risks of using electrical heating devices.
The Kashmiriyat spoke to the Doctors Association Kashmir (DAK) president and influenza expert, Dr. Nisar Ul- Hassan, who said, “Most deaths that are caused from Asphyxia happen because the gas can not be detected by the human eye. It silently kills. There are just symptoms that can be distinguished. Fatigue, dizziness, headaches, and the patients can sometimes present with chest pains, confusion. Rhythm disturbances and convulsions are also common. Last year, there were deaths in Bemina, Qamarwari and North Kashmir in Pattan.”
“All the sudden deaths were results of carbon monoxide poisoning as all families had the heating appliances on in an enclosed space and in the morning they were dead”.
Dr. Nisar also said, “Even if people do not use a gas heater for prolonged hours and frequently, they can still have chronic problems from exposure to the low concentration of carbon monoxide. We have seen patients coming in with memory loss, neurological disorders, movement disorders from the exposure.
Unless as doctors, we dig down a patient’s history, there is no possible way of diagnosing asphyxia. Last year, a family from Handwara, was found unconscious by their neighbors. The family suffered from asphyxia due to carbon monoxide. The wife unfortunately did not survive. We saved the husband and he was under medical observation for three months”.
Talking about measures to avoid carbon monoxide poisoning and asphyxia, Dr. Nisar said, “We have to bring this to the attention of people. Using heating appliances can be dangerous and fatal if not used in ventilated spaces like bedrooms, washroom. Please make sure, there is a proper vent secured for air to regulate. These heaters should not be used for more than 4 hours at a stretch and must be in a ventilated room”.
Earlier reports state that nine lives were lost in winter from suffocation due to gas and other heaters, in 2019 2020. Doctors have since, alerted masses over the use of such appliances especially during the night. Five members of a family from Tangdhar died of suffocation in their rented accommodation in Srinagar’s Bemina area today while three non-local labourers died due to asphyxiation at Shou village in south Kashmir’s Kulgam district in intervening night of December 11 and 12 last year.
Snow Shoveler’s Risk:
Heart attacks that are triggered by shoveling snow are distressingly common. In a study published in 2012, investigators looked at 500 patients who were treated for Acute Coronary Syndrome (ACS) over two consecutive winters. They found that 7 percent of these cardiac emergencies were directly related to snow-shoveling. Further, they found that being a male and having a family history of premature heart disease were each strongly associated with ACS caused by shoveling snow.
Shoveling snow, by definition, is a cold-weather exercise, and in cold weather, vasoconstriction (narrowing of the blood vessels) occurs in the small blood vessels, which also increases blood pressure and produces significant cardiac stress. Furthermore, breathing in cold air can constrict the airways and make it more difficult to deliver the extra oxygen the heart needs during periods of excessive stress.
Unlike conventional exercise, shoveling is usually done without a warm-up and can cause a sudden increase in blood pressure and heart rate. Additionally, cold air may cause constriction of blood vessels, including coronary arteries, and decrease oxygen supply to the heart. Together, these factors can increase the heart’s workload and cause a heart attack.
Cold temperatures themselves can provoke spasm of certain arteries — even coronary artery spasm — in some people. Anyone with any degree of CAD is at higher risk for an acute cardiac event while shoveling snow. This risk goes up substantially in people who are generally sedentary and deconditioned.
Dr. Nisar- Ul- Hassan also spoke to The Kashmiriyat about the risks of snow shoveling and said, “Shoveling is a risk of manual labor and health that people take on their own if continued for prolonged hours. If someone suffers from electrical rhythm disorder, hypertrophic cardiomyopathy (a condition where heart muscles become abnormally thick) and congenital heart disease take up shoveling, where they take up abrupt stress and physical labor. Shoveling can result in a sudden heart attack or arrhythmia.”
“Shoveling is a risk that can be fatal too. Smokers, people at risk of cholesterol, hypertension, diabetes and other underlying health issues can die from the excessive stress on the heart”.
“We have seen many patients, who come in after shoveling and present with chest pains or myocardial infarction. It is very important that people understand these risks and use machines instead of manual labor. Prolonged hours of shoveling and heavyweight on the shovel is not recommended. Everyone can not be at this risk, especially people who have been shoveling aggressively for years, their body somehow develops a tolerance towards the labor in harsh weathers, but a risk is a risk.”
“All lives are precious, even if one patient dies in hundreds who were shoveling, as doctors, it will be significant for us. It is a risk which is scientifically proven,” Dr. Nisar concluded.
Preventive Measures to avoid fatal health conditions while shoveling is probably warming up before shoveling. It is advised that an individual must take a few minutes to stretch, move about and get the ‘blood flowing’ before undertaking any strenuous activity, including shoveling snow.
A smaller shovel should also be preferred instead of heavy tools. A shovel full of wet snow is especially heavy when the shovel is big. It may take a little longer, but many small loads will be better than fewer heavy ones. Dressing appropriately, to avoid health risks which include, covering hands, head and mouth will help inhale warmer air and also helps avoid respiratory problems.
Shoveling in shifts is recommended by health experts. Taking 15-minute breaks can help lessen the load on your heart and to avoid extreme exhaustion. Heavy exertion, too quickly, can trigger a heart attack — especially in the cold — when arteries tend to constrict, which in turn, can drive up blood pressure.