Guide to Heat-Related Illness and Injury

Take appropriate precautions to protect your employees who work outdoors in the heat.  If you are in California, this is mandatory. People suffer heat-related illness, or hyperthermia, when their bodies are unable to properly cool themselves, which it normally does by sweating.  Very high body temperatures may damage the brain or other vital organs.

THINGS YOU NEED TO KNOW:

1.       While some signs of heat-related illness are mild, if you intervene early enough, you may be able to prevent those that will be a true and dangerous medical emergency.

2.       Employees need more than just water and shade—they need to be trained to take proper care of themselves in the heat.

3.       There are conditions other than just working outdoors that can exacerbate heat stress, for example, age, obesity, fever or illness, dehydration, heart disease, high blood pressure, poor circulation, sunburn, strenuous physical activities, and prescription drug or alcohol use.

Action Steps
The best contacts and resources to help you get it done

Recognize Heat-Related Illness

Symptoms can include swollen feet/ankles, sunburn, dizziness, rash, heavy sweating, headaches, muscle cramps, rapid heart beat, feeling faint or fainting. Rash, sunburn, and swollen feet typically do not require medical treatment unless they are severe, but dizziness, fainting ,rapid heart beat and other symptoms need attendion and can indicate more serious medical problems.

I recommend: The Ontario (Canada) Ministry of Labour has a guide that has a good chart of symptoms and how to treat them at http://www.labour.gov.on.ca/english/hs/guidelines/gl_heat.html.

Assess the Environment

Are the conditions hotter than usual? Determine where shade and water are (or can be) located and how they will be adjusted or replenished if/when necessary. Determine when it’s hottest and whether any of the work can be shifted in the coolest times of the day.

I recommend: OSHA provides a list of factors to check at http://www.osha.gov/dts/osta/otm/otm_iii/otm_iii_4.html#iii:4_1 and employer guidelines can also be found on www.occupationalhazards.com,

Screen for Exacerbating Conditions

Screen applicants and workers for conditions that could make them more vulnerable to heat stress—e.g., high blood pressure, obesity. Perhaps they can be redirected to other work. Not being used to the heat can also be an exacerbating factor. You might want a work plan that allows new workers to acclimatize before working in full heat.

I recommend:
 A good chart can be found on the American Physicnan site //www.aafp.org/afp/980901ap/barrow.html.

Provide Adequate Shelter and Water.

Workers need to do more than rest on their breaks—they need to cool off. They need to rest somewhere out of the heat. There needs to be adequate shade to allow bodies to cool down. California regulations require at least one quart of water per employee per hour, which can be a good guideline even if your state doesn’t have specific requirements. California’s new heat stress guidelines can be found in their Code of Regulations.

I recommend:

You can use California's new regulations as a model. They are at http://www.dir.ca.gov/Title8/3395.html.

Make sure workers take their breaks.

Some states require regular breaks, most do not. Nonetheless, if you have people working in the heat, you will want to establish regular rest breaks. In California, penalties for denying mandatory breaks for employees are severe.

I recommend: You can take a look at the Califoria rest break regulations  at http://www.dir.ca.gov/dlse/FAQ_RestPeriods.htm

Train Supervisors

Your training plan should include a) how to recognize signs of heat stress, b) what to do in the case of various levels of heat stress, c) how and to whom to report incidents of heat stress, d) what to do when an employee suffers from heat stress, and particularly in case of an emergency, e) emergency telephone numbers, F) location of medical facility designated to treat ill or injured workers.

I recommend: OSHA Publication 3154 is a quick guide for supervisors and it’s also available in Spanish. http://www.osha.gov/Publications/osha3154.html

Train Employees.

Train employees to a) take steps to avoid heat stress (for example, not drinking caffeine or alcohol, b) recognize signs of heat stress, c) know when and how to report symptoms of heat stress (theirs or that of co-workers), d) know location of shade and water, e) know location of designated medical facility, f) have no fear in raising the issue of heat related illness. OSHA’s employee guide is available in English and Spanish.

I recommend: http://www.osha.gov/Publications/OSHA3166/osha3166.html
http://www.bt.cdc.gov/disasters/extremeheat/heattips.asp
http://www.redcross.org/services/hss/tips/heat.html

Tips & Tactics
Helpful advice for making the most of this Guide

• Make emergency cards for supervisors with instructions and phone numbers.
• Make and post a map to the nearest medical facility that can treat emergencies.
• Train supervisors not to retaliate or discriminate against workers who report heat stress problems or complain about lack of shade water.
• Make sure your drinking water and related supplies are sanitary.
• Assign workers in high heat environments to a "buddy" so that they can look out for each other and watch for heat stress.