Taking the stress out of heat

Even though resources are plentiful and the cost of prevention is minimal, every year, thousands of workers become sick from exposure to heat and some die. Heat related exposure includes not only heat cramps, heat rash, heat exhaustion, fainting and heat stroke, but also injuries from falls, equipment operation and accidents that occur when a worker has sweaty palms or fogged safety glasses or becomes dizzy, disoriented, or fatigued as a result of dehydration.

The problem is not limited to those who work outside. Those who work around machinery and in confined spaces, such as mechanics, steamfitters, ship builders, plumbers, bakery workers, boiler room workers, drycleaners and so on can be at risk for heat stress. Fully encapsulated protective clothing also increases sweat rates, accelerating dehydration.

Here are some basic steps to protect workers:

• Train supervisors and employees about heat stress, how it affects their health and safety, the warning signs and how it can be prevented. There are many valuable resources readily available such as OSHA's Heat/Illness webpage and NIOSH's Heat Stress page. The OSHA site has resources and training tools, many of which target vulnerable workers with limited reading skills or limited English. It also includes a helpful smartphone app, The Heat, that uses weather data from the National Oceanic and Atmospheric Administration and GPS technology to determine the risks factors associated with working outside on a given day. The Heat app provides users with the current temperature and humidity, allows workers and supervisors to calculate the heat index for their worksite, and provides a reference tool if a worker begins to show signs of a medical condition. The Heat is available in both English and Spanish on a wide variety of mobile platforms including iPhone, Blackberry and Android.
• Create and implement a worker-acclimatizing plan. To ensure workers are fully acclimatized to heat, OSHA suggests employers begin with 50 percent of the normal workload and time spent in the hot environment, gradually building up exposure and workload to 100 percent by the fifth day. Further, OSHA says new workers and those returning from vacations should repeat the five-day minimum adjustment period. Moreover, it's important to recognize that one size does not fit all. According to NIOSH, while workers can acclimatize themselves to different levels of heat, each worker has an upper limit for heat stress beyond which that worker can become a heat casualty. This varies by body size, state of wellness, lifestyle, etc. Workers and employers need to understand what puts them at greater risk.
• Know the factors that increase the risk of heat stress, such as heart disease, high blood pressure, pregnancy, age (over 65), diabetes, and alcohol consumption. In addition, certain medications, including anti-psychotics and anti-cholinergics, are known to increase the risk of heat stroke because they inhibit the body's ability to regulate its temperature.
• Provide plenty of cool, fresh water, encourage employees to drink water frequently AND continue to observe and monitor for symptoms of heat stress. It is a common misconception that taking fluids to hydrate the body is enough to prevent heat stress; however, in certain circumstances it can take as much as 24-hours for the body to absorb enough fluid to fully rehydrate, so watch for the signs. Furthermore, some symptoms of heat exhaustion, such as irritability, thirst, headache and heavy sweating, can be rationalized as "normal" in hot environments. There is a natural tendency to minimize the significance of these early warning signs.
• Prepare an emergency heat illness prevention plan for the worksite, with training for supervisors and workers on the steps to take if a worker shows signs or symptoms of heat illness.
• Provide a shaded area for workers to take a cool down recovery break.
• Have effective communication systems in place to summon emergency assistance if necessary.
• As in all job training, language, reading proficiency and cultural barriers need to be taken into account.