{"id":6899,"date":"2013-07-01T00:00:00","date_gmt":"2013-07-01T00:00:00","guid":{"rendered":"https:\/\/insulation.org\/io\/articles\/heat-illness-prevention\/"},"modified":"2013-07-01T00:00:00","modified_gmt":"2013-07-01T00:00:00","slug":"heat-illness-prevention","status":"publish","type":"articles","link":"https:\/\/insulation.org\/io\/articles\/heat-illness-prevention\/","title":{"rendered":"Heat Illness Prevention"},"content":{"rendered":"

As warmer
\nweather moves across the country, affecting more U.S. workers, it becomes
\nincreasingly important for companies to focus on protection from heat-related
\nillness. A discussion of legal requirements for employers related to the
\nGeneral Duty Clause and the need to address heat stress was featured in an
\narticle titled “Heat Stress and the General Duty Clause” by NIA’s legal counsel
\nGary Auman in the October 2012 issue of Insulation Outlook<\/i>, available at
\nwww.InsulationOutlook.com<\/i>. The following article discusses some of the
\nsymptoms of heat illness and offers ideas and resources for those looking to
\nstrengthen or develop a heat illness prevention program for their workers. This
\narticle seeks to start a discussion about this issue, and readers are encouraged
\nto speak to their own experts and legal counsel about how to create a plan and
\nprotect their employees. If you have any concerns about the adequacy of your
\nheat illness prevention program, you are encouraged to consult with your
\ncompany physician regarding the environment in which your employees work and
\nthe safeguards you have in place.<\/span><\/p>\n

Heat illness is a serious condition that claims lives every year. If
\nyour heat illness prevention program consists of simply making water coolers
\navailable to your employees, you may be putting your workforce at risk. Because
\nof the significant number of individuals affected, the Occupational Safety and
\nHealth Administration (OSHA) is emphasizing the need for all construction
\ncompanies to have a heat illness prevention program in place that includes
\neffective training of all employees. High temperatures, high humidity, radiant
\nheat sources, and strenuous physical activity are all risk factors for heat
\nillness, and these are all common workplace conditions in the insulation trade.
\nA comprehensive heat illness prevention plan is an important part of any
\nenvironmental, health, and safety program. As the summer season begins, it is
\ncrucial to evaluate your safety programs to ensure you are doing everything
\nnecessary to guarantee the safety and health of your employees.<\/span><\/p>\n

Heat Illness Symptoms<\/font><\/b><\/p>\n

Heat illness refers to a range of health problems
\nthat occur when a person cannot maintain a normal body temperature. A person’s
\nbody temperature depends on environmental conditions and the heat generated
\nthrough physical exertion. Excess body heat is controlled primarily by
\nperspiration. When a person cannot effectively shed excess body heat, then heat
\nillness may occur. Heat illness can take several forms, from mild heat cramps
\nto life-threatening heat stroke. <\/p>\n

Exposure to hot environmental conditions, other heat sources, and
\nmetabolic heat (from exertion) are the primary risk factors for heat illness.
\nMany other factors, however, can contribute to an individual’s likelihood of
\ndeveloping the condition, including diet, hydration, medication, pre-existing
\nconditions such as high blood pressure and diabetes, obesity, and even sunburn.
\nThese factors, combined with the necessary use of personal protective equipment
\nand work clothing, contribute to thousands of workers becoming ill and being at
\nrisk for serious complications, including death.<\/span><\/p>\n

Heat cramps are a mild form of heat illness, but they should be viewed as
\na red flag for more serious problems. Heat cramps are the result of dehydration
\nand a loss of salt. A person suffering heat cramps may not require medical
\nattention as long as certain precautions are taken, including taking a break
\nfrom activity and rehydrating with water or a sports drink. Salt tablets are
\ngenerally not recommended unless directed by a doctor, as a normal, healthy
\ndiet should replace salt loss. Everyone should drink more fluids than usual
\nduring hot periods, even if they do not feel thirsty. Thirst is a signal that
\nyou may already be dehydrated. An easy teaching point to pass on to your
\nemployees is to monitor the color of their urine. Dark-colored urine is a
\nclassic sign of dehydration.<\/span><\/p>\n

Heat exhaustion is a more
\nserious form of heat illness that is caused by a loss of salt and fluids. It
\ncan occur gradually over several days or happen more suddenly. Heat exhaustion
\nis characterized by heavy sweating, pale skin, tiredness, weakness, dizziness,
\nand nausea. An individual affected by heat exhaustion will have a rapid, weak
\npulse rate and fast, shallow breathing. Although heat exhaustion is treatable,
\nit should not be taken lightly, as it can progress to heat stroke. Workers
\nsuffering from heat exhaustion also may be less alert or confused, and
\ntherefore be at greater risk for accidents. These workers should be removed
\nfrom the work area and escorted to a cooling off area. At the cooling off area
\nthey should be monitored and the Mayo Clinic recommends that they drink cool
\nliquids and have wet towels, ice packs, or cooling blankets applied to their
\nskin after removing excess clothes while you consult with medical personnel.
\nSitting them in front of a fan or misting the person with water may also help
\ncool them down. Be aware that further treatment, including medical help and
\nintravenous (IV) fluids may be needed to help them rehydrate. Remember, you
\nshould not just direct them to a cooling area, but personally escort them, as
\nthey may be disoriented. An individual who is suspected to be suffering from
\nheat illness should not be left alone or be expected to obtain their own treatment.\n<\/p>\n

Heat stroke is the most serious form of heat illness. It occurs when the
\nbody becomes unable to regulate its own temperature. Heat stroke is
\ncharacterized by rapidly rising body temperature, the cessation of an
\nindividual’s sweating mechanism, and the body being unable to cool down. Heat
\nstroke can cause death or permanent disability in a matter of minutes or hours
\nand may lead to brain damage, loss of kidney <\/span>function, and other organ damage. Warning signs of heat stroke include
\nflushed, hot, and dry skin; a lack of sweat; rapid, strong pulse; headache;
\nconfusion; muscle cramps or weakness; nausea and dizziness; and loss of
\nconsciousness. You should immediately call for emergency medical assistance if
\nyou suspect someone is suffering from heat stroke. To treat heat stroke
\nimmediately while waiting for medical assistance, the American Red Cross
\nrecommends complete immersion (up to the victim’s neck) in cool water, if
\npossible.<\/span> <\/p>\n

Resources for Employers<\/font><\/b><\/p>\n

Several government agencies and consensus groups
\noffer guidelines for preventing heat illness in the workplace. OSHA has an
\nongoing campaign to prevent heat illness in outdoor workers. OSHA’s website, www.osha.gov<\/a><\/i>,
\ndetails the agency’s outreach initiative, which stresses the core components of
\nwater, rest, and shade. The website offers educational and training resources
\nfor employers, and information on using the heat index—a temperature value that
\nfactors in relative humidity. Since the sweating mechanism is less effective at
\ncooling a worker’s body in high humidity environments, the heat index, which
\ncombines temperature with humidity, should be the resource used to determine
\nwhat safeguards to put in place. Users of the chart are cautioned that the
\nnumbers on the chart are meant to refer to work that is out of direct sunlight;
\nthe chart indicates that if work is in the sun with little or no breeze, then
\n15 degrees should be added to the temperature component.<\/span> <\/p>\n

Although Federal OSHA does not have a specific standard on heat illness,
\nSection 5(a)(1) of the OSH Act, known as the General Duty Clause—which is
\ndescribed in the October 2012 article mentioned previously—states that
\nemployers must provide “employment and a place of employment which are free
\nfrom recognized hazards that are causing or are likely to cause serious
\nphysical harm…” It is clear from OSHA’s campaign on heat illness that the
\nthreat presented by this condition, which can have serious detrimental effects,
\nis real. Therefore, employers have a legal obligation to provide safeguards for
\ntheir employees to protect them from the hazardous effects of heat illness.<\/span><\/p>\n

Employers with operations in
\nCalifornia should be aware that Cal\/OSHA has a standard on Heat Illness
\nPrevention for workers in outdoor places of employment. The standard has
\nrequirements for the provision of drinking water, access to shade, training for
\nemployees and supervisors, and observation of employees working in high-heat
\nsituations. The Cal\/OSHA standard is a good starting point for an organization
\nlooking to develop a heat illness prevention program. It contains clear and
\nstraightforward instructions with trigger points for specific control measures
\nat different temperatures. <\/p>\n

Another resource for employers is the American Conference of
\nGovernmental Industrial Hygienists (ACGIH), which is generally recognized as
\nhaving the most current exposure limits for workplace contaminants and physical
\nagents. The ACGIH publishes an exposure limit to protect workers from the
\neffects of heat illness. That exposure limit, called a Threshold Limit Value—or
\nTLV—takes into account environmental conditions, workload, and protective
\nclothing. The ACGIH TLV is based on a special temperature reading called a Wet
\nBulb Globe Temperature (WBGT), which factors in relative humidity and radiant
\nheat sources such as direct sunlight. The TLV determines a work-to-rest ratio
\ndepending on the WBGT reading and the workload. The services of a safety and
\nhealth professional, or a representative from your Workers Compensation
\ncarrier, may be needed to perform a heat stress evaluation using the ACGIH
\nthreshold limit value.<\/span><\/p>\n

Another helpful resource is the National Institute for Occupational
\nSafety and Health, an agency established to assure safe working conditions for
\nemployees. The NIOSH criteria document for heat stress is fairly simple to use
\nand sets out a 5-part program that should, if followed, provide more than
\nadequate protection for your employees.<\/span> <\/p>\n

Developing a Heat Illness Prevention Plan<\/font><\/b><\/p>\n

If you determine
\nthere is the potential for heat illness after evaluating your workplace, you
\nshould develop a comprehensive heat illness prevention plan. The plan should
\ninclude training for workers and supervisors, procedures for acclimatization,
\ncontrol measures, methods for cooling workers off, steps for caring for
\nheat-related illness, and emergency procedures. <\/span><\/p>\n

Training for employees and
\nsupervisors should include the types of heat illness and risk factors,
\nprevention of heat illness, signs and symptoms of heat illness, care and
\nemergency treatment, as well as the control measures to reduce or prevent heat
\nillness. Training should emphasize that employees should immediately report any
\nsigns or symptoms of heat illness in themselves or observed in others to a
\nsupervisor.<\/p>\n

Control measures in the plan
\nshould include (but are not limited to):<\/p>\n