Sourced from OSHA.gov and CDC.gov
Millions of U.S. workers are exposed to heat in their workplaces. Although illness from exposure to heat is preventable, thousands become sick from occupational heat exposure every year, and some cases are fatal. Most outdoor fatalities, 50% to 70%, occur in the first few days of working in warm or hot environments because the body has yet to build a tolerance to the heat over time. Construction workers, in particular, are highly susceptible to heat-related illnesses. Services providing industries, such as trade, transportation, warehousing, and utilities, are also at risk of heat stress.
Heat-Related Illnesses (HRIs)
Several heat-related illnesses can affect workers. Some of the symptoms are non-specific. When a worker is performing physical labor in a warm environment, any unusual symptom can be a sign of overheating. Heat rash, heat cramps, heat exhaustion, and heat stroke are the four most common HRIs.
- How it happens: Occurs when sweat ducts become clogged, and sweat can’t get to the surface of the skin.
- Symptoms: Red blister-like eruptions, bumps, and an itching sensation.
- How to treat it: Keep the skin dry and rest in a cool place.
- How it happens: Salt and moisture levels are depleted through perspiration.
- Symptoms: Painful spasms, usually in the legs or abdomen.
- How to treat it: Move to a cool, shaded area, apply something cool, drink plenty of fluids.
- How it happens: Prolonged exposure to high temps and inadequate hydration causing body temps to rise.
- Symptoms: Headaches, weakness, mood change, feeling sick, pale and/or clammy skin.
- How to treat it: Move to a cool, shaded area, apply something cool, drink plenty of fluids, and monitor.
- How it happens: When the body becomes unable to control its core body temp.
- Symptoms: Pale skin, nausea, vomiting, confusion.
- How to treat it: Seek medical attention immediately.
Employers and workers should become familiar with the heat symptoms. When any of these symptoms are present, promptly provide first aid. Do not try to diagnose which illness is occurring. Diagnosis is often difficult because symptoms of multiple heat-related illnesses can occur together. Time is of the essence as these conditions can worsen quickly and result in fatalities.
Personal Risk Factors
Hazardous heat exposure can occur indoors or outdoors during any season if the conditions are right, not only during heat waves. Occupational risk factors for heat illness include heavy physical activity, warm or hot environmental conditions, lack of acclimatization, and wearing clothing that holds in body heat. Heat intolerance happens for a variety of reasons. Some workers handle heat stress less effectively than others. Some personal risk factors include:
- Obesity (body mass index ≥ 30 kg/m2)
- High blood pressure
- Heart disease
- A lower level of physical fitness
- Use of certain medications such as diuretics (water pills) and some psychiatric or blood pressure medicines
- Some medications can result in a worker's inability to feel heat conditions and/or the inability to sweat, so symptoms of heat stress may not be evident.
- Alcohol use
- Use of illicit drugs such as opioids, methamphetamine, or cocaine
Employers should recognize that not all workers tolerate heat the same way. Workplace controls should focus on making jobs safe for all employees. An occupational medical monitoring program can identify workers with an increased risk of heat illness while maintaining the confidentiality of workers’ health information.
When heat hazards are present, workers should receive training about personal factors that can make them more susceptible to heat-related illness. When in doubt, workers should talk to their healthcare provider about whether they can work safely in the heat.
Creation of a Heat Illness Prevention Plan
Employers should create a written plan to prevent heat-related illness. Important elements to consider when creating the heat plan are:
- Who will provide oversight daily?
- How will new workers gradually develop heat tolerance?
- Temporary workers may be more susceptible to heat and require closer supervision.
- Workers returning from extended leave (typically more than two weeks) may also be at increased risk.
- How will the employer ensure that first aid is adequate and the protocol for summoning medical assistance in situations beyond first aid is effective?
- What engineering controls and work practices will be used to reduce heat stress?
- How will heat stress be measured?
- How to respond when the National Weather Service issues a heat advisory or heat warning.
- How will we determine if the total heat stress is hazardous?
- What training will be provided to workers and supervisors?
Heat conditions can change rapidly, and management commitment to adjusting heat stress controls is critical to preventing heat illness. An appointed individual at the worksite should be responsible for monitoring conditions and implementing the employer's heat plan throughout the workday. This individual can be a foreman, jobsite supervisor, plant manager, safety director, or anyone else with the proper training. Proper training includes knowing how to:
- Identify and control heat hazards;
- Recognize early symptoms of heat stress;
- Administer first aid for heat-related illnesses; and
- Activate emergency medical services quickly when needed.
Train workers before hot outdoor work begins and tailor training to cover worksite-specific conditions. Employers should provide a heat stress training program for all workers and supervisors about the following:
- Recognition of the signs and symptoms of heat-related illnesses and administration of first aid.
- Causes of heat-related illnesses and the procedures that will minimize the risk, such as drinking enough water and monitoring the color and amount of urine output.
- Proper care and use of heat-protective clothing and equipment and the added heat load caused by exertion, clothing, and personal protective equipment.
- Effects of nonoccupational factors (drugs, alcohol, obesity, etc.) on tolerance to occupational heat stress.
- The importance of acclimatization.
- The importance of immediately reporting to the supervisor any symptoms or signs of heat-related illness in themselves or coworkers.
- Procedures for responding to symptoms of possible heat-related illness and for contacting emergency medical services.
In addition, supervisors should be trained on the following:
- How to implement appropriate acclimatization.
- What procedures to follow when a worker has symptoms consistent with heat-related illness, including emergency response procedures.
- How to monitor weather reports.
- How to respond to hot weather advisories.
- How to monitor and encourage adequate fluid intake and rest breaks.
Heat-related illnesses can be prevented. Prevention requires employers and workers to recognize heat hazards and to have the proper equipment and solution in place. Below are recommendations for the jobsite, especially during the hottest months.
Shelter + Shade
Provide a reprieve from direct sunlight and an area for workers to rest, recover, and cool down.
- A Portable work shelter or umbrella combined with a misting system provides relief from the heat.
It’s easier than you think to get dehydrated. Proper hydration before, during, and after work shifts is critical.
- Drink small amounts of water frequently.
- Hydration packs encourage more fluid intake than bottles, and ensure workers are never without cool, clean water.
- During prolonged sweating lasting several hours, drink sports drinks containing balanced electrolytes.
Personal Protective Equipment (PPE)
Designed to cool, transport moisture, block sunlight or reduce direct sun exposure, proper PPE provides key factors in mitigating HRIs.
- Evaporative cooling towels, head bands, vests, and more combine water and airflow and help keep the body’s core temperature regulated.
- Wear light-colored, loose-fitting, breathable clothing—cotton is good.
- Know that equipment such as respirators or work suits can increase heat stress.
OSHA makes the following recommendations to block those harmful rays:
- Cover up. Wear loose-fitting, long-sleeved shirts and long pants.
- Use sunscreen with a sun protection factor (SPF) of at least 30. Be sure to follow application directions on the bottle or tube.
- Wear a hat. A wide brim hat, not a baseball cap, works best because it protects the neck, ears, eyes, forehead, nose, and scalp.
- Wear UV-blocking sunglasses (eye protection). Sunglasses don’t have to be expensive, but they should block 99 to 100 percent of UVA and UVB radiation. Before you buy sunglasses, read the product tag or label.
- Limit exposure. UV rays are most intense between 10 a.m. and 4 p.m.
Food, Drink, Rx
- Eat smaller meals before work activity.
- Avoid caffeine and alcohol or large amounts of sugar.
- Find out from your health care provider if your medications and heat don’t mix.
OSHA’s Medical Services and First Aid standard and the Medical Service and First Aid in Construction require the ready availability of first aid personnel and equipment. First aid for heat-related illness involves the following principles:
- Take the affected worker to a cooler area (e.g., shade or air conditioning).
- Cool the worker immediately. Use active cooling techniques such as:
- Immerse the worker in cold water or an ice bath. Create the ice bath by placing all available ice into a large container with water; This is the best method to cool workers rapidly in an emergency.
- Remove outer layers of clothing, especially heavy protective clothing.
- Place ice or cold wet towels on the head, neck, trunk, armpits, and groin.
- Use fans to circulate air around the worker.
- Never leave a worker with heat-related illness alone. The illness can rapidly become worse. Stay with the worker.
- When in doubt, call 911!
Confusion, slurred speech, or unconsciousness are signs of heatstroke. When these symptoms are present, call 911 immediately and cool the worker with ice or cold water until help arrives.
Heat-related illnesses and fatalities are 100% preventable when you know the risks, symptoms, and solutions. Reach out to your ABATIX Rep today to learn more about heat stress solutions for your team.