Heat Stress and Heat Stress and Electrolyte Electrolyte

Replenishment with Replenishment with ElectrolytesElectrolytes

elete Electrolyte Add-In, a division of Mineral elete Electrolyte Add-In, a division of Mineral Resources International, Inc.Resources International, Inc.

1990 West 3300 South1990 West 3300 SouthOgden, UT 84401Ogden, UT 84401

United StatesUnited States

Exclusively distributed across the Middle East byExclusively distributed across the Middle East byBudge FZ-LLC, PO Box 502969, Dubai, UAEBudge FZ-LLC, PO Box 502969, Dubai, UAE

Tel: +971 (0)4 446 2972Tel: +971 (0)4 446 2972www.eletewater.ae www.eletewater.ae

OverviewOverview Heat Stress DefinedHeat Stress Defined Symptoms of Heat Stress Symptoms of Heat Stress The Causes of Heat StressThe Causes of Heat Stress Limitations of Sports Drinks/Oral Rehydration Salts Limitations of Sports Drinks/Oral Rehydration Salts

(ORS)(ORS) Preventing Heat-Related Health Disorders with elete Preventing Heat-Related Health Disorders with elete

Electrolyte Add-InElectrolyte Add-In Limitations of Sports Drinks/ORSLimitations of Sports Drinks/ORS Advantages of elete ElectrolytesAdvantages of elete Electrolytes Comparing elete with Other Electrolyte-Replacement Comparing elete with Other Electrolyte-Replacement

ProductsProducts Further Risk-Reduction StrategiesFurther Risk-Reduction Strategies

What is Heat Stress?What is Heat Stress? The human body attempts to The human body attempts to

maintain an internal temperature maintain an internal temperature of 37of 37° Celsius° Celsius

Hot weather, physical labour, Hot weather, physical labour, other heat sources can raise the other heat sources can raise the body’s temperature, which the body’s temperature, which the body will attempt to reduce by body will attempt to reduce by pumping blood to the skin’s pumping blood to the skin’s surface.surface.

The body will also try to lower its The body will also try to lower its temperature through sweat, i.e., temperature through sweat, i.e., water and minerals excreted water and minerals excreted through the skin, which are then through the skin, which are then evaporated to aid cooling. evaporated to aid cooling.

The adverse effects of heat stress The adverse effects of heat stress can range from mild to life-can range from mild to life-threatening.threatening.

Symptoms of Heat StressSymptoms of Heat Stress During physical labor, a body During physical labor, a body

can lose can lose 1-2 litres of 1-2 litres of water/hourwater/hour..

After 2-3 hours of fluid loss, a After 2-3 hours of fluid loss, a person can experience the person can experience the following adverse effects:following adverse effects:

Loss of energy/enduranceLoss of energy/endurance Physical discomfortPhysical discomfort Feeling hotFeeling hot ThirstyThirsty

After 3 hours of exposure:After 3 hours of exposure: Muscle cramps & fatigueMuscle cramps & fatigue HeadachesHeadaches Physical weaknessPhysical weakness Loss of dexterityLoss of dexterity Reduced alertnessReduced alertness NauseaNausea SeizuresSeizures

After 3-6 hours, heat cramps, After 3-6 hours, heat cramps, heat exhaustion sets in. Heat heat exhaustion sets in. Heat exhaustion leads to heat exhaustion leads to heat stroke (an internal body stroke (an internal body temperature of 40temperature of 40° Celsius or ° Celsius or more)more), which is life-threatening , which is life-threatening and must be treated by trained and must be treated by trained medical professionals. medical professionals.

Symptoms of Heat StressSymptoms of Heat Stress

Heat RashHeat Rash Red, blister-like lesionsRed, blister-like lesions ItchingItching

Heat CrampsHeat Cramps Excruciating muscle Excruciating muscle

cramps and spasmscramps and spasms

Heat ExhaustionHeat Exhaustion Headaches,dizziness, Headaches,dizziness,

weakness, nausea, weakness, nausea, vomiting, extreme vomiting, extreme sweating, dark-colored sweating, dark-colored urine, pale, clammy skinurine, pale, clammy skin

Heat StrokeHeat Stroke Nausea and vomiting, hot, Nausea and vomiting, hot,

red skin (sunburn), red skin (sunburn), irritability, confusion, irritability, confusion, seizures, collapse, seizures, collapse, unresponsive, high body unresponsive, high body temperaturetemperature

Causes of Heat StressCauses of Heat Stress Environmental FactorsEnvironmental Factors (temperature, (temperature,

direct sun, heat humidity)direct sun, heat humidity) The more direct sun, the greater the The more direct sun, the greater the

riskrisk Low or no wind Low or no wind Hot equipment & reflected heatHot equipment & reflected heat

WorkloadWorkload How much effort is being exerted?How much effort is being exerted?

Clothing Clothing Heavy, multiple layers, non- Heavy, multiple layers, non-

“breatheable,” dark clothing k“breatheable,” dark clothing k Personal Risk Factors Personal Risk Factors

Drug and alcohol useDrug and alcohol use Existing medical conditions Existing medical conditions

(hypertension, heart conditions, (hypertension, heart conditions, diabetes) diabetes)

Medications (antihistamines, blood Medications (antihistamines, blood pressure, heart,laxatives, mental pressure, heart,laxatives, mental health, seizure, thyroid)health, seizure, thyroid)

The Electrolytes in SweatThe Electrolytes in Sweat In a six-hour period (under In a six-hour period (under

desert conditions), sweat desert conditions), sweat loss (and corresponding loss (and corresponding electrolyte losses) can electrolyte losses) can measure:measure:

Sweat Loss: 3.5 litresSweat Loss: 3.5 litres Potassium Loss: 23-70mEqPotassium Loss: 23-70mEq Na Loss: 72-244 mEqNa Loss: 72-244 mEq

During strenuous exertion, During strenuous exertion, magnesium sweat losses magnesium sweat losses can approximate between can approximate between 10-25% of the daily loss. 10-25% of the daily loss.

The Limitations of Sports DrinksThe Limitations of Sports Drinks Sodium is not the only electrolyte lost in sweat. Sodium is not the only electrolyte lost in sweat.

Makers of sports drinks assume sodium (Na) is the only or “main” electrolytes people loseMakers of sports drinks assume sodium (Na) is the only or “main” electrolytes people lose Na is the most consumed mineral in the diet. Therefore, it should come as no surprise it is excreted more Na is the most consumed mineral in the diet. Therefore, it should come as no surprise it is excreted more

than any other electrolytethan any other electrolyte Na is typically cheap to add to beverages; while other electrolytes (magnesium and potassium) are more Na is typically cheap to add to beverages; while other electrolytes (magnesium and potassium) are more

expensiveexpensive Most electrolyte-replacement drinks omit magnesium (Mg), an essential mineral that plays Most electrolyte-replacement drinks omit magnesium (Mg), an essential mineral that plays

a crucial role in the bodya crucial role in the body 80% of cell ATP (adenosine triphosphate) is complexed with with Mg80% of cell ATP (adenosine triphosphate) is complexed with with Mg Mg involved in ensuring adequate blood flow to muscle and organs, maintains acid-base balance, Mg involved in ensuring adequate blood flow to muscle and organs, maintains acid-base balance,

normalizes excitation and contraction in nerve and muscle—including cardiac tissue—involved in nerve normalizes excitation and contraction in nerve and muscle—including cardiac tissue—involved in nerve conduction, muscle contraction, membrane transport, cell division, even the synthesis of DNA and RNA.conduction, muscle contraction, membrane transport, cell division, even the synthesis of DNA and RNA.

Magnesium acts as a “team captain” of the electrolytes; it keeps sodium outside the cell and potassium Magnesium acts as a “team captain” of the electrolytes; it keeps sodium outside the cell and potassium inside the cellinside the cell

Magnesium is to the muscle what calcium is to the bonesMagnesium is to the muscle what calcium is to the bones Maintaining optimal magnesium balance is crucial. The body does not “acclimatize” to magnesium Maintaining optimal magnesium balance is crucial. The body does not “acclimatize” to magnesium

deficiency.deficiency. Magnesium deficiency linked with heart disease, sudden cardiac death, insulin resistanceMagnesium deficiency linked with heart disease, sudden cardiac death, insulin resistance Most people don’t consume adequate amounts of magnesium from foods (Green, leafy vegetables are the Most people don’t consume adequate amounts of magnesium from foods (Green, leafy vegetables are the

predominant Mg-rich food source)predominant Mg-rich food source) Most sports drinks are laden with sugar and artificial preservatives.Most sports drinks are laden with sugar and artificial preservatives. Compared to sweat, they Compared to sweat, they

still contain dilute amounts of sodium and potassium. still contain dilute amounts of sodium and potassium. It’s a common misconception that sports drinks can prevent hyponatremia, diluted blood-sodium levelsIt’s a common misconception that sports drinks can prevent hyponatremia, diluted blood-sodium levels Consumers of sports drinks will consume significant amounts of sugar long before they receive adequate Consumers of sports drinks will consume significant amounts of sugar long before they receive adequate

amounts of fluid and electrolytesamounts of fluid and electrolytes It’s not uncommon for people to complain of nausea, GI distress while using sports drinks It’s not uncommon for people to complain of nausea, GI distress while using sports drinks

Limitations of Sports DrinksLimitations of Sports Drinks Many workers and athletes complain of Many workers and athletes complain of

gastrointestinal (GI) upset and nausea using gastrointestinal (GI) upset and nausea using sports drinks. Once this occurs, many will be sports drinks. Once this occurs, many will be reluctant to continue to drink a sports drinks in reluctant to continue to drink a sports drinks in order to stay hydrated, prevent dehydration order to stay hydrated, prevent dehydration (vicious circle)(vicious circle)

Nausea and GI distress result in decreased Nausea and GI distress result in decreased productivityproductivity

For workers (especially older) who might have For workers (especially older) who might have specific health considerations (hypertension, specific health considerations (hypertension, diabetes, etc.), sports drinks high in sodium, diabetes, etc.), sports drinks high in sodium, sugar pose unique challenges to their healthsugar pose unique challenges to their health

Overconsumption of energy-dense sports drinks Overconsumption of energy-dense sports drinks can lead to substantial weight gain in workerscan lead to substantial weight gain in workers

In providing sports drinks to its workers, many In providing sports drinks to its workers, many workers have to be trained on how to overcome workers have to be trained on how to overcome problems such as strong distaste of the drinks, problems such as strong distaste of the drinks, mouthfeel (gagging), and GI distress assoc. mouthfeel (gagging), and GI distress assoc. with these products (e.g., temperature)with these products (e.g., temperature)

Sports drinks (powders) have to be dissolved Sports drinks (powders) have to be dissolved and mixed according to manufacturer’s and mixed according to manufacturer’s guidelinesguidelines

The problems of too dilute vs. too The problems of too dilute vs. too concentrated concentrated

MessyMessy Clean up required Clean up required

Sports drinks are linked with accelerated Sports drinks are linked with accelerated enamel erosion, dental caries, etc. enamel erosion, dental caries, etc.

Preventing Heat Stroke Preventing Heat Stroke Wear appropriate Wear appropriate

clothingclothing Take regular breaksTake regular breaks Recognize the signs of Recognize the signs of

heat stressheat stress Drink water frequently. Drink water frequently. Add elete electrolytes to Add elete electrolytes to

drinking, portable water drinking, portable water to replace essential to replace essential electrolytes that electrolytes that regulate fluid balanceregulate fluid balance

TWLTWL Level 1Level 1(<140 W. m(<140 W. m-2-2))sitting, standing, sitting, standing, light hand/arm light hand/arm workwork

Level 2Level 2(140-180 W. m(140-180 W. m-2-2))sitting, standing, sitting, standing, heavy arm work, heavy arm work, walking with light walking with light arm workarm work

Level 3Level 3(180-220 W. m(180-220 W. m-2-2))walking, moderate walking, moderate lifting or pushinglifting or pushing

Level 4Level 4(>220 W. m(>220 W. m-2-2))carrying, climbing, carrying, climbing, whole body workwhole body work

= 115= 115 >1.2*>1.2* >1.2*>1.2* >1.2*>1.2* >1.2*>1.2*

116-150116-150 1.0-1.21.0-1.2 >1.2*>1.2* >1.2*>1.2* >1.2*>1.2*

140-180140-180 0.8-1.00.8-1.0 1.0-1.21.0-1.2 >1.2*>1.2* >1.2*>1.2*

180-220180-220 0.5-0.80.5-0.8 0.8-1.20.8-1.2 1.21.2 >1.2*>1.2*

>220>220 0.3-0.50.3-0.5 0.5-0.80.5-0.8 0.8-1.00.8-1.0 1.21.2

Required fluid intake to maintain hydration during workRequired fluid intake to maintain hydration during work

Red indicates extreme thermal stress. Essential maintenance and rescue work only.

Orange indicates workload exceeds TWL. Work-rest cycling must be applied

Yellow indicates high thermal stress. No worker to work alone

Green indicates moderate thermal stress. No accimatised worker to work alone.

Blue indicates low thermal stress. Unrestricted self-paced work.

HAAD Recommendations – Choice of Fluid HAAD Recommendations – Choice of Fluid Replacement DrinksReplacement Drinks

If workers are sweating heavily between means, an electrolyte replacement drink is recommended. Replacing salt (replacing electrolytes) as it is lost helps the body absorb and If workers are sweating heavily between means, an electrolyte replacement drink is recommended. Replacing salt (replacing electrolytes) as it is lost helps the body absorb and retain the water consumed:retain the water consumed:

Sports drinks are high is sugar and often quite acidic which can damage teeth. They are not designed for prolonged consumption at workSports drinks are high is sugar and often quite acidic which can damage teeth. They are not designed for prolonged consumption at work For prolonged consumption, a fluid with 4% or less sugar is recommendedFor prolonged consumption, a fluid with 4% or less sugar is recommended Appropriate products designed for industrial use are available commerciallyAppropriate products designed for industrial use are available commercially The suggested drink schedule is to drink the electrolyte replacement fluid at every second drink (i.e. One for one with water)The suggested drink schedule is to drink the electrolyte replacement fluid at every second drink (i.e. One for one with water) For diabetics or those on sugar restricted diets, medical advice is required on the preferred fluids for rehydrationFor diabetics or those on sugar restricted diets, medical advice is required on the preferred fluids for rehydration

Replacement of the fluid lost in sweat requires intake of adequate quantities of water and salt. Replacement of the fluid lost in sweat requires intake of adequate quantities of water and salt. Drinking at mealtimes replaces both and is essential. Remember to encourage workers to:Drinking at mealtimes replaces both and is essential. Remember to encourage workers to:

Add a little extra salt to their meals during hot weather, salt tablets are NOT recommended.Add a little extra salt to their meals during hot weather, salt tablets are NOT recommended. Drink Water with mealsDrink Water with meals Limit consumption of soft drinks as the sugar content is highLimit consumption of soft drinks as the sugar content is high Limit consumption of caffeinated drinks (coffee, tea, cola) and ‘energy drinks’ as the caffeine may reduce Limit consumption of caffeinated drinks (coffee, tea, cola) and ‘energy drinks’ as the caffeine may reduce

fluid retentionfluid retention

For more information visit the HAAD Safe Website

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What is elete?What is elete? elete Electrolyte Add-In is a pure, liquid, electrolyte elete Electrolyte Add-In is a pure, liquid, electrolyte

concentrate, which contains 4 essential concentrate, which contains 4 essential electrolytes—magnesium, potassium, sodium, and electrolytes—magnesium, potassium, sodium, and chloride—to support fluid balance, muscle chloride—to support fluid balance, muscle function, energy production, heat tolerance, nerve function, energy production, heat tolerance, nerve conduction, stamina, etc. conduction, stamina, etc.

elete instantly infuses water with essential elete instantly infuses water with essential electrolytes and, when mixed as directed, adds electrolytes and, when mixed as directed, adds minimal flavor. elete makes pure electrolyte water minimal flavor. elete makes pure electrolyte water that tastes like waterthat tastes like water

elete provides the same amount of potassium, an elete provides the same amount of potassium, an essential mineral, as Gatorade® and Powerade®, essential mineral, as Gatorade® and Powerade®, but also provides magnesium, which is not but also provides magnesium, which is not typically found in electrolyte-replenishment drinks typically found in electrolyte-replenishment drinks (sports drinks).(sports drinks).

elete is a “must” for individuals, work crews or elete is a “must” for individuals, work crews or anyone needed to maintain adequate hydration, anyone needed to maintain adequate hydration, energy, and proper muscle function under grueling energy, and proper muscle function under grueling conditions of heat stress, fluid loss, and exertion.conditions of heat stress, fluid loss, and exertion.

For a demonstration of the Solubility of elete For a demonstration of the Solubility of elete Electrolytes in water, click the logo Electrolytes in water, click the logo

elete Electrolyte Add-Inelete Electrolyte Add-In

Advantages of eleteAdvantages of elete Balanced electrolyte profile. Four vs. twoBalanced electrolyte profile. Four vs. two elete contains magnesium, the “team captain” of electrolytes, essential for energy elete contains magnesium, the “team captain” of electrolytes, essential for energy

production, muscle function, electrolyte controlproduction, muscle function, electrolyte control When mixed as directed, elete adds minimal flavor to waterWhen mixed as directed, elete adds minimal flavor to water Very easy to mix and use. Very easy to mix and use. Clean up is easy. elete will not stain, leave a residue, or contribute to the growth of Clean up is easy. elete will not stain, leave a residue, or contribute to the growth of

mold in coolers, hydration packs, canteens, etc. mold in coolers, hydration packs, canteens, etc. Very safe, Generally Recognize as Safe, a U.S. Food and Drug designation.Very safe, Generally Recognize as Safe, a U.S. Food and Drug designation. In a published, peer-reviewed clinical study, those who drank plain water, drank 74% In a published, peer-reviewed clinical study, those who drank plain water, drank 74%

moremore water to achieve the same level of hydration as those who drank water with water to achieve the same level of hydration as those who drank water with eleteelete..

Backed by numerous testimonials from athletes (professional and amateur), coaches, Backed by numerous testimonials from athletes (professional and amateur), coaches, trainers, teams, workerstrainers, teams, workers

Certified free of all WADA (World Anti-Doping Agency)-banned substances by Certified free of all WADA (World Anti-Doping Agency)-banned substances by Informed-ChoiceInformed-Choice

Manufactured at a GMP (Good Manufacturing Practices)-certified company. Manufactured at a GMP (Good Manufacturing Practices)-certified company. Certification provided by NSF InternationalCertification provided by NSF International

Tested for potency and purity at in-house quality assurance laboratory and Tested for potency and purity at in-house quality assurance laboratory and independent, third-party labsindependent, third-party labs

Advantages of elete for Advantages of elete for Industrial ApplicationsIndustrial Applications

Natural, healthy hydration (no added Natural, healthy hydration (no added sugar, no artificial ingredients) sugar, no artificial ingredients)

Reduce number of heat stress Reduce number of heat stress incidents to zeroincidents to zero

elete provides a better balance of elete provides a better balance of electrolytes lost in sweat (replaces electrolytes lost in sweat (replaces four—not two electrolytes)four—not two electrolytes)

The most cost effective solution The most cost effective solution available GUARANTEED available GUARANTEED

Flexible sizes from 1 litre to 400 Flexible sizes from 1 litre to 400 litres litres

Easy to mix and useEasy to mix and use Because of its flexibility, workers Because of its flexibility, workers

can hydrate with watercan hydrate with water Won’t cause GI distressWon’t cause GI distress Used with great success by military Used with great success by military

personnel in medically treating personnel in medically treating severe cases of heat stresssevere cases of heat stress

Clinically Proven to Improve Clinically Proven to Improve HydrationHydration

• In a peer-reviewed published study (In a peer-reviewed published study (Wild & Env Wild & Env Med, Med, 19, 172-180 (2008), people who drank 19, 172-180 (2008), people who drank water alone drank 74% water alone drank 74% moremore water than those water than those who drank electrolyte water made with elete.who drank electrolyte water made with elete.

• ““In summary, the addition of an electrolyte In summary, the addition of an electrolyte mixture [elete] to plain water was associated mixture [elete] to plain water was associated with a decrease in overall fluid consumption of with a decrease in overall fluid consumption of the water + electrolyte group by 220 mLthe water + electrolyte group by 220 mL h h-1 -1 or or 3.3 L 3.3 L d d-1-1..” ” –John S. Cuddy, et al. –John S. Cuddy, et al.

• Commenting on the study, renowned Commenting on the study, renowned emergency physician and founding member of emergency physician and founding member of the Wilderness Medical Society, Paul S. the Wilderness Medical Society, Paul S. Auerbach said, “Auerbach said, “This [study] suggests that This [study] suggests that supplementing water with electrolytes might supplementing water with electrolytes might reduce the amount of fluid necessary to reduce the amount of fluid necessary to transport and consume during extended transport and consume during extended activity. This would minimize excessive weight, activity. This would minimize excessive weight, which in and of itself might contribute to a which in and of itself might contribute to a lessening of fatigue.”lessening of fatigue.”

• Auerbach listed Auerbach listed eleteelete among his “Top 4 Items among his “Top 4 Items of Medical Equipment,” “…I will never travel of Medical Equipment,” “…I will never travel anywhere that I expect to need to stay hydrated anywhere that I expect to need to stay hydrated without bringing along without bringing along eleteelete.”.”

Product Product 

Per 250-mL (*except where noted)Per 250-mL (*except where noted)

Sodium Sodium (mg)(mg)

Magnesium Magnesium (mg)(mg)

PotassiumPotassium(mg)(mg)

EnergyEnergy(kJ)(kJ)

ContainsContainsArtificial Artificial IngredientsIngredients

SupportsSupportsCustomizedCustomized

DosingDosing

elete Electrolytes elete Electrolytes 3232 12 (chloride)12 (chloride) 3434 00 NoNo YesYes

Carbo ShotzCarbo Shotz 215215 10 (sulfate)10 (sulfate) 2121 1212 YesYes NoNo

Aqualyte Aqualyte 70 70 00 3030 153153 YesYes NoNo

Gatorade G2Gatorade G2 115115 00 3030 126126 YesYes NoNo

PoweradePowerade 101101 00 2626 212212 YesYes NoNo

Staminade Endure*Staminade Endure* 3838 50 (oxide)50 (oxide) 5050 309309 YesYes NoNo

Hydralyte*Hydralyte* NANA NANA NANA NANA YesYes NoNo

Pocari Sweat*Pocari Sweat* 4949 0.6 (carbonate)0.6 (carbonate) 2020 2626 NoNo NoNo

Oral rehydr. salts Oral rehydr. salts (ORS)*(ORS)* 3.5g3.5g 00 1.5g1.5g NANA NoNo NoNo

                 

Compare elete for YourselfCompare elete for Yourself

* All sizes based on 250-ml except as follows: elete 240-ml, Staminade, 350-ml; Hydralyte and ORS on 1 liter; Pocari Sweat, 100-ml. For an expanded product comparison, visit: http://new.eletewater.com/why-elete/compare-elete/ Certain forms of minerals (e.g., oxide, carbonate, etc.) are associated with a lower bioavailability vs. other mineral forms.

Further Risk-Reduction Strategies Further Risk-Reduction Strategies (Our Recommendations)(Our Recommendations)

Train workers on heat stress, heat Train workers on heat stress, heat stroke, and general hydration strategies stroke, and general hydration strategies (both for themselves and co-workers) (both for themselves and co-workers) including when and how much to drink including when and how much to drink and how they can use elete in their water and how they can use elete in their water or beverages, food, etc.or beverages, food, etc.

Use the larger, elete refill bottles to mix Use the larger, elete refill bottles to mix elete and make electrolyte water in all of elete and make electrolyte water in all of the worker hydration stations, water the worker hydration stations, water coolers, hydration packs, water tanks, coolers, hydration packs, water tanks, etc. available on each job site and to etc. available on each job site and to each workereach worker

Designate point personnel who can Designate point personnel who can supply workers with electrolyte water and supply workers with electrolyte water and elete electrolytes at strategic times and elete electrolytes at strategic times and locations to ensure workers are receiving locations to ensure workers are receiving enough water and electrolytesenough water and electrolytes

Staff aid stations with water and elete. Staff aid stations with water and elete. Encourage workers to lie down, rest, and Encourage workers to lie down, rest, and drink water with elete.drink water with elete.