The Current·Q&A

Arizona is so hot pavements are giving people third-degree burns, says doctor

Scorching temperatures are pummeling Phoenix, breaking records and prompting spikes in heat-related illnesses, injuries and even deaths.

'Unfortunately, the mortality associated with this is fairly high': Dr. Kevin Foster

A man rests under the shade of an umbrella and a tree.
A Phoenix, Ariz., resident rests under shade while seeking protection from the sun and heat at the Human Services Campus in Phoenix. (Patrick T. Fallon/AFP)

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For a record-breaking 20 days, Phoenix, Ariz., has been dealing with temperatures exceeding 110 F (43 C).

The weeks-long heatwave, which broke a municipal record set in 1974, has gotten so bad that residents are getting third-degree burns after touching doorknobs, or falling onto the pavement.

As of July 15, at least 18 people have died of heat-associated causes in Phoenix in 2023, according to the Maricopa County Department of Public Health. Another 69 suspected heat deaths are also under investigation.

Dr. Kevin Foster is the director of the Arizona Burn Centre in Phoenix. He said these kinds of burns are expected in the summer, but this year, the incidence of burns is "twice the normal that we typically see — and it's not immediately obvious why that is."

Here's part of his conversation with The Current guest host Rosemary Barton.

A shelter and cooling centre for homeless people.
People watch a movie, hydrate and rest inside the Justa Center, a Phoenix day cooling centre for homeless people 55 years and older. (Matt York/The Associated Press)

What kind of burns are you seeing at your centre right now?

The summertime is always a busy time because of the hot ambient temperatures and sunlight and stuff makes it hot and makes contact burns really a common thing in the summertime.

This summer, because the temperatures are really hot right now and direct sunlight, we are seeing lots of patients who are falling down onto the concrete, pavement, asphalt, and suffering really, really deep burns as a result of that.

You mentioned pavement. What other things are people getting burned on or with?

Anything that's in direct sunlight and exposed to the hot temperatures outside. 

Another common thing we see is hot door handles, hot upholstery in cars, a variety of things within vehicles like the steering wheel, dashboards, seat belt buckles. 

Then something that people don't think about very often, but hose water or water that's in a hose that's outside. Oftentimes, it's very near boiling. 

Even if you let it run for a while, the water in Arizona does not get cold or cool. It always stays hot.

A close-up view of a water jug being filled in Phoenix, Arizona.
A person fills a water jug during a record-breaking heat wave in Phoenix. (Brandon Bell/Getty Images)

How hot are these things? Like, how hot is the pavement? Do you have a sense?

We've tested it over the years and it's pretty consistent that on a hot summer afternoon in Arizona, black asphalt can get 170 to 180 degrees [F; between 76 and 83 C], which is just a little bit below boiling.

What kind of shape are people in? 

People go down for a reason. Oftentimes it's elderly people who take a fall and can't get up, or medication-related or related to ongoing medical problems.… We' 're seeing, you know, a fair number of homeless people. 

It tends to make these injuries really, really bad because people just stay down for a prolonged period of time.

A man walks under misters.
A man walks along a Phoenix sidewalk under the misters. (Matt York/The Associated Press)

What kind of degree of burns are you talking about?

Almost always third-degree burns. Almost all of these patients require admission to the hospital, frequently to the intensive care unit, and almost all of them are requiring surgeries — and most of them, multiple surgeries. 

What about, in terms of your medical clinic, seeing a heat-related illness?

This is something that we see very commonly, very often. 

It almost always accompanies these deep burns. When people go down and they don't get up right away, almost always, they suffer heat shock or heat prostration. That can be, you know, central nervous system problems, liver failure, kidney failure. So, yeah, that is a problem. 

And then, we see a fair number of patients here that don't even have cutaneous burns, but they're suffering from heat shock. 

That tends to be a big problem with people who are visiting here. Most native Arizonans have a pretty healthy respect for hot temperatures and direct sunlight. We avoid it; we don't go outside in the middle of the afternoon. 

But oftentimes, people who are visiting here don't realize how hot it actually is and how quickly you can get dehydrated and suffer heat shock.

Are people dying? I mean, maybe not from the burns, but the heat shock and the other things as well?

Yeah, unfortunately, the mortality associated with this is fairly high. 

I mean, most people get better. Most of the people that we admit to the burn centre, we expect are going to do fine. 

This particular disease entity seems to have a higher mortality associated with it than you would expect for the extent or the depth of the wound.

A person lies on the ground next to a bottle of water.
A person lays on the floor at a cooling centre at the First Congregational United Church of Christ in Phoenix. (Brandon Bell/Getty Images)

What would you like to see authorities do to try and help those people … deal with these kinds of extreme temperatures?

I think that most businesses do a pretty good job taking care of the workers. They make sure that they're working in the shade as much as possible, take frequent breaks, have exposure to a place to cool off … and lots of hydration.

But I think for homeless people, it's a problem. We do need to provide better shelters for people and a way for people to get out of the heat. 

And I think that it's really important that people … stay hydrated. It's misleading here because the humidity is really low and it doesn't feel quite as hot as it really is.

People will go out for a walk and dip pretty far away and then suddenly realize, oh boy, I'm in trouble — and by that time you are in trouble.

ABOUT THE AUTHOR

Mouhamad Rachini is a Canadian Lebanese writer and producer for CBC Radio's digital team. He's worked for CBC Radio shows including Day 6 and Cross Country Checkup. He's particularly passionate about telling stories from Muslim and Middle Eastern communities. He also writes about soccer on his website Between the Sticks. You can reach him at mouhamad.rachini@cbc.ca.

Q&A edited for length and clarity. Produced by Niza Lyapa Nondo and Juliana Konrad

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