Ron Falk lost his right leg, underwent a major skin graft on his left leg and is still recovering a year after collapsing on the hot asphalt outside a Phoenix convenience store where he had stopped for a cold soda during a heat wave.

Now in a wheelchair, the 62-year-old has lost his job and his home. He is recovering at a medical respite center for patients with nowhere else to go, where he is receiving physical therapy and treatment for a bacterial infection in what remains of his right leg, which is too swollen to use the prosthesis he hoped would help him walk again.

“If you don’t go somewhere to cool off, the heat will affect you,” said Falk, who lost consciousness from heatstroke. “Then you won’t know what’s happening, like I did.”

Matt York/AP

Ron Falk, 62, puts on his prosthetic leg, Tuesday, June 25, 2024, in Phoenix. Falk lost his right leg, underwent extensive skin graft surgery on his left leg and is still recovering a year after collapsing on the hot asphalt outside a convenience store where he had stopped for a cold soda during a scorching heat wave. (AP Photo/Matt York)

Hot sidewalks and unshaded playgrounds pose surface burn risks as air temperatures reach new summer highs in Southwest cities like Phoenix, which just recorded its hottest June on record. The average daytime high was 109.5 degrees Fahrenheit (43 degrees Celsius), with no 24-hour high below 100 degrees Fahrenheit (37.7 degrees Celsius).

Young children, the elderly and the homeless are particularly at risk for contact burns, which can occur within seconds when skin touches a surface that is 180 degrees Fahrenheit (82 degrees C).

Since the beginning of June, 50 people have been hospitalized with such burns and four have died at Valleywise Health Medical Center in Phoenix, which operates the largest burn center in the Southwest, serving patients from Arizona, New Mexico, Utah, Nevada, Southern California and Texas, according to its director, Dr. Kevin Foster. About 80 percent of the people injured were in metropolitan Phoenix.

Last year, the center admitted 136 patients for superficial burns from June to August, compared to 85 during the same period in 2022, Foster said. Fourteen died. One in five was homeless.

“Last year’s record heat wave resulted in an alarming number of patients suffering life-threatening burns,” Foster said of a 31-day stretch, including all of last July, with temperatures at or above 110 degrees (43 C) during Phoenix’s hottest summer on record.

In Las Vegas, where infections regularly top 10% in the summer, 22 people were hospitalized at the Lions Burn Care Center at University Medical Center in June, spokesman Scott Kerbs said. That’s nearly half the number of people hospitalized during the three summer months last year.

As in Phoenix, the desert sun punishes Las Vegas for hours each day, scorching outdoor surfaces like asphalt, concrete, metal car doors and playground equipment like swings and monkey bars.

Victims of superficial burns often include children injured by walking barefoot on hot concrete or touching hot surfaces, adults who collapsed on a sidewalk while intoxicated, and elderly people who fell to the sidewalk due to heatstroke or other medical emergency.

Some do not survive.

Heat injuries were among the leading or contributing causes of the 645 heat-related deaths last year in Maricopa County, which includes Phoenix.

One of the victims was an 82-year-old woman with dementia and heart disease who was admitted to a suburban Phoenix hospital after being found on the scorching sidewalk on an August day when temperatures reached 106 degrees.

With a body temperature of 40.5°C, the woman was rushed to hospital with second-degree burns on her back and right side, covering 8% of her body. She died three days later.

Matt York/AP

Phoenix firefighters provide medical care to a homeless man, Thursday, May 30, 2024, in Phoenix. Hot sidewalks and unshaded playgrounds pose increasing risks to surface buns as air temperatures soar to new highs during scorching summers in Southwestern cities like Phoenix and Las Vegas. Very young children and the elderly are particularly at risk for contact burns. So are the homeless. (AP Photo/Matt York)

Many patients with superficial burns also suffered potentially fatal heatstroke.

Valleywise Hospital’s emergency department recently adopted a new protocol for all heatstroke victims, submerging patients in a bag of crushed ice to quickly lower body temperature.

Recovery for people with skin burns was often lengthy, with patients requiring multiple skin grafts and other surgeries, followed by months of convalescence in skilled nursing or rehabilitation facilities.

Bob Woolley, 71, suffered second- and third-degree burns to his hands, arms, legs and torso after he tripped on the scorching rock garden of his Phoenix home wearing only a bathing suit and tank top.

“The ordeal was extremely painful, it was almost unbearable,” said Woolley, who was hospitalized at the Valleywise burn center for several months. He said he considers himself “95 percent recovered” after numerous skin grafts and physical therapy and has resumed some of his former activities like swimming and motorcycling.

Some of the skin burn victims in both Phoenix and Las Vegas were children.

“In many cases, it involves toddlers walking or crawling on hot surfaces,” Kerbs said of those hospitalized at the Las Vegas center.

Foster said about 20 percent of inpatient and outpatient skin burn victims seen at the Phoenix center are children.

Young children are not fully aware of the damage that can be caused by a hot metal doorknob or a hot sidewalk.

“Because they’re playing, they’re not paying attention,” says urban climatologist Ariane Middel, an assistant professor at Arizona State University who leads the SHaDE Lab, a research team that studies the effects of urban heat.

“They may not even realize it’s hot.”

By measuring the surface temperature of playground equipment, the team found that in 100°F (37.7°C) weather with no shade, a slide can heat up to 160°F (71.1°C), but a surface can lower that temperature to 111°F (43.8°C). Rubber flooring can reach 188°F (86.6°C), a ramp can heat up to 120°F (48.8°C), and concrete can reach 132°F (55.5°C).

Many parks in metropolitan Phoenix have covered picnic tables and plastic tarps stretched over playground equipment, which can keep metal or plastic surfaces up to 30 degrees cooler. But many don’t, Middel said.

She explained that cooler wood chips are easier on the feet than rubber mats, which are designed to protect children from head injuries but absorb heat from the hot sun. Like rubber, artificial turf gets hotter than asphalt.

“We need to think about alternative types of surfaces because most of the surfaces we use for our infrastructure are heat sponges,” Middel said.

Hot concrete and asphalt also pose burn hazards to pets.

Veterinarians recommend dogs wear booties to protect their paws during outdoor walks in the summer, or keep them on cooler grassy areas. Owners are also advised to make sure their pets drink plenty of water and don’t overheat. Phoenix prohibits dogs from accessing popular hiking trails in the city on days when the National Weather Service issues an excessive heat warning.

Recovering at Circle the City in Phoenix, a respite care facility where he was sent after being released from the Valleywise burn unit, Falk said he never imagined the Phoenix heat would have him collapsing on the hot asphalt in his shorts and T-shirt.

With no identification or phone on him, no one knew where he was for months. He still has a long way to go, but he still hopes to regain some of his old life, working for an entertainment events concessionaire.

“I found myself in a downward spiral,” Falk admitted. “I finally woke up and was like, ‘Hey, wait, I lost a leg.’ But that doesn’t mean you’re useless.”