National Extension Risk Management Education Conference
April 17, 2007 -- Phoenix
National Extension Risk Management Education Conference
April 17, 2007 -- Phoenix
Education to Help Manage
Old and New Risks of
Heat Stress on CA & AZ Farms
Howard Rosenberg
University of California, Berkeley
Trent Teegerstrom
University of Arizona, Tucson
Heat for fun
Heat as a Problem
Excess Heat Can Harm
• Heat stress: An accumulation of heat in
the body that raises core temperature and
threatens normal functioning.
• Heat illness: A breakdown of normal
physical or mental functioning that is
caused by heat stress directly or by the
body’s response to it.
Heat "illnesses"
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Heat stroke
Heat exhaustion
Heat syncope (fainting)
Heat cramps
Heat rash, other skin ailments
Subtle impairment - physical & mental
Heat Illnesses / First Aid
Heat rash
Regarded as least severe of heat illnesses, occurs when sweat clogs pores. Though
heat rash usually causes only temporary discomfort, it can develop into an infection.
Cleanse the affected area thoroughly and dry completely. Calamine or
other soothing lotion may help relieve the discomfort.
Heat syncope
Most likely to affect people who are not acclimatized to working in hot
environments. Syncope generally is the sudden loss of consciousness due to lack of
sufficient blood and oxygen to the brain. Heat stress can cause it by "diverting" blood
to the lower body or extremities at the expense of the brain.
Rest in shade, drink plenty of water or electrolyte fluids.
Heat cramps
Often extremely uncomfortable and can be completely disabling. Heat cramps typically
occur during or after hard work and are caused by electrolyte deficiencies that result
from extended periods of intense sweating. Symptoms include painful spasms of leg,
arm or abdominal muscles, heavy sweating, and thirst.
Rest, drink plenty of water or electrolyte fluids.
More Heat Illnesses / First Aid
Heat exhaustion
Also occurs during work but results from dehydration, lack of acclimatization, reduction of
blood in circulation, strain on circulatory system, and reduced flow of blood to the
brain. Symptoms of heat exhaustion include fatigue, headache, dizziness, muscle
weakness, nausea, chills, tingling of hands or feet, confusion, loss of coordination,
fainting and collapse.
Rest in the shade or cool place. Drink plenty of water (preferred) or
electrolyte fluids.
Heat stroke
Can occur suddenly if heat exhaustion is not treated, and it can be fatal. At this extreme
state of heat stress, the body typically has a core temperature exceeding 104 degrees
F and can no longer cool itself. A person suffering heat stroke needs immediate
attention and should be taken to a medical facility as soon as possible.
A medical emergency! Brain damage and death are possible. Douse the body
continuously with a cool liquid and summon medical aid immediately.
More Hazards from Heat
Besides causing illness, heat stress raises
risk of accidents and poor performance.
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Physical discomfort
Weakness or cramping
Sweaty, slippery hands
Blurry vision, fogged glasses
Slower mental and physical reactions
Diverted attention, loss of concentration
Lapses in judgment
Irritability and anger
Dizziness, confusion, nausea, fainting
Translating into Business Cost$
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poor quality work and decisions
damage to product and equipment
operational disruptions
1st aid and medical treatment
replacement of disabled workers
increased WC insurance
New Rules
Gore movie and Fresbee news headline
The rest of this hour . . .
1. Heat stress physiology 101
2. The new CA regulation
3. RME project in California
4. RME project in Arizona
5. Lessons and unknowns
The rest of this hour . . .
1. Heat stress physiology 101
2. The new CA regulation
3. RME project in California
4. RME project in Arizona
5. Lessons and unknowns
Physiology of Heat Stress - 1
During both rest and
activity, the human body
tries to maintain an
internal temperature of
98.6 F.
Where does the heat that
stresses us come from?
Avg Daily High Temps in CA & AZ
May
Jun
Jul
Aug
Sep
Oct
Cloverdale
77.5
84.9
90.7
90.0
86.2
77.9
Modesto
81.5
88.9
94.1
92.3
87.4
78.3
Watsonville
66.2
67.8
70.2
71.2
73.2
71.8
Yuma
94.2
103.3
106.6
105.3
100.5
90.3
Phoenix
93.6
103.5
105.9
103.7
98.3
88.1
Bakersfield
84.6
92.3
98.4
96.4
90.0
80.6
El Centro
94.1
104.0
108.0
106.2
101.3
90.0
A Very Hot Day?
Activities Generate Heat
activity
kcal/hour
Resting
60-90
Standing
90-120
Driving
120-180
Factory work
210-400
Walking, flat surface
300-400
Construction tasks
300-600
Swimming
300-880
Regulation of Body Temperature
• Thermal "challenges"
 Cold
 Heat
• Responses and coping adjustments
 Behavioral
 Autonomic (no thinking)
Physiology of Heat Stress - 2
• Activity and outside heat
sources raise the body’s
core temperature.
• Heated blood is pumped to
outer layers of body, from
which it radiates and conducts
to the environment, if cooler.
• If heat has to be shed faster,
glands produce more sweat
that carries it through pores
to skin surface, from which it
evaporates to accelerate
cooling.
Physiology of Heat Stress - 3
• The longer a body sweats, the
less blood there is to carry
excess heat to skin or oxygen
and nutrients to muscles.
• After 3 hours, a dehydrated
worker may experience:
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Headaches
Muscle fatigue
Loss of strength
Loss of accuracy and dexterity
Heat cramps
Reduced alertness
Nausea
Heat Stress Effects if Fluid not Replaced
Level
Cum. fluid loss
% Body wt.
Time till*
Symptoms and effects
Minor dehydration
1.5 lb. (.75 L)
1%
1 hr.
Generally not perceived.
Incipient stress
3.0 lb. (1.5 L)
2%
2 hrs.
Begin thirsty, hot, minor discomfort.
Moderate stress
4.0 lb. (2.25 L)
3%
3 hrs.
Loss of energy, muscle endurance.
High stress
6-9 lb. (3-4 L)
4-6%
4-5 hrs. Impaired coordination, endurance.
Low energy, strength. Fatigue, cramps.
Very high
(exhaustion)
9-12 lb. (4-5.5 L)
6-8%
6-7 hrs.
Headache, dizziness, nausea,
Serious fatigue.
Emergency
(stroke)
11+ lb. (5+ L)
7+%
7+ hrs.
High temperature. Confusion. Loss
of consciousness.
* based on a 150 lb. male doing moderately active work in hot weather and not replacing fluids
Environmental and personal factors
affect the rates at which
bodies gain and lose heat.
General Recap:
Physiological Response to Heat
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Work activity produces heat
“Core” body temperature rises
Heart rate speeds up and veins dilate
Blood flow carrying heat to skin increases
Sweat glands activate and draw water
Body loses water and salts
Bloodstream volume and service decrease
Functions decline and heat illness may present
Recommended Self-care
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Learn about recognition, treatment, physiology
Monitor environment and assess own risk
Work easier until "acclimatized"
Try to do heavier jobs in cooler hours
Work in shade if possible; avoid full sun
Wear lightweight clothing and protective gear
Take rest periods or reduce pace
Drink sufficiently and timely to replace lost fluids
How Much?
Fluid Replenishment Guidelines
U.S. Army, NIOSH & other research:
• 25 oz./hr. during moderate work at 82-90 deg.
• 33 oz./hr. during heavy work at 90+ deg.
• Don’t wait for thirst
• Rest every hour, a lot
• Drinks small amounts frequently (drip, not flood)
Recommended Management
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Monitor environment and provide alerts
Evaluate and modify work assignments
Allow a few days for acclimatization of new hires
Schedule heavier jobs for cooler hours
Adjust rest period frequency and length
Provide shaded work and/or rest stations if possible
Control cab climate for machine operators
Consider cooling garments or devices
Educate about recognition, treatment, physiology
Encourage frequent fluid consumption
Field Observations
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Water generally available
State of the art is "igloo"
Infrequent visits to it
Large quantities drunk each visit
Much less consumption than advisable
Hypo-hydration likely
Less access taken while on piece-rate
Why not replenish enough?
• "Costs" to access the water
 Physical effort
 Earnings opportunity
 Supervisor approval
 Co-worker respect
• Impetus to drink
 Thirst-driven
 Some fears, concerns about real effect
 Understanding of need and function
So what more can managers do?
• Reduce various costs of access
• Support through foremen and culture
• Strive to educate. Help workers understand
the physiology and recognize symptoms
The rest of this hour . . .
1. Heat stress physiology 101
2. The new CA regulation
3. RME project in California
4. RME project in Arizona
5. Lessons and unknowns
Other Pertinent Law
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The "general duty" under OSHA
§3203. Injury & Illness Prevention Program
§3439. First Aid
§3457. Field Sanitation
ALRA -- "protected concerted activity"
Milestones toward §3395
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1984: petition from L.A. librarians union & others
1990: petition from sister of Rosa Elvia Durazo
2000: Cal/OSHA advisory committee formed
2004-05: heat-related fatalities, other cases
Feb. 2005 - AB 805 introduced in CA Legislature
• Aug. 12, 2005 - OSHSB adopts emergency rule
• June 15, 2006 - OSHSB adopts permanent standard
“We only hear about it
when it becomes a tragedy”
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Edwardo Jimenez Chavez, 60 -- July 2002
Jose Asuncion Valdivia, 53 -- July 2004
Salud Zamudio Rodriguez, 42 -- July 2005
Ramon Hernandez -- July 2005
Augustine Gudino, 40 -- July 2005
Constantino Cruz Hernandez, 24 -- July 2005
. . . additional serious cases in 2005 . . .
Cal OSHSB - June 15, 2006
The New Regulation
• Sec. 3395 - "Heat Illness Prevention"
• in CCR Title 8: Ch. 4, Subchapt. 7, Article 10
• Authority: CA Labor Code, Section 142.3
• Emergency standard: Aug. 2005 - Jul. 2006
• Permanent standard effective July 27, 2006
Basic Requirements
1. Provide 1 quart of water per person-hour
2. Provide access to shaded rest area, 5+ min.
3. Provide training
- all employees
- supervisory employees
4. Document compliance and response plans
applicable to all outdoor workplaces, all the time
Training Topics for Workers
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Environmental and personal "risk factors"
Importance of frequent water consumption
Importance of acclimatization
Common signs and symptoms of heat illness
Importance of immediately reporting signs to employer
Employer’s procedures for responding to symptoms
Emergency contact & transportation procedures
How employer will assure good directions in emergency
Other procedures for complying with this standard
The rest of this hour . . .
1. Heat stress physiology 101
2. The new CA regulation
3. RME project in California
4. RME project in Arizona
5. Lessons and unknowns
Envisioned Outcomes
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More and better education for field workers
Reduced "costs" of access to drinking water
Increased water consumption to replenish
Decreased workplace injuries & illnesses
Less personal hurt and lower business costs
Project Design Considerations
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Generally poor understanding of the risk
Manager and worker acts needed to reduce risk
Managers best target for direct education
Support "cascading" to supervisors and workers
Partnerships for audience access and leverage
Primary Target Audience
• Farm labor contractors in CA
1,200 licensees
 9,600 first-line supervisors
 300,000 - 400,000 production workers
 perform ~35% of all ag production work in CA
• 600 in FLCEI continuing education
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Project Activity
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FLCEI classes: 11 English, 10 Spanish, 871 pts
Other seminars, workshops: 9 (+), 534 pts (+)
Coaching and technical support for educators
Handouts, slide sets, web pages
Articles, print & broadcast releases (36 items)
Seminar Co-sponsors
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Agricultural Safety Resource Alliance
AgSafe Coalition
California Floral Council
California League of Food Processors
Farm Employers Labor Service
Western Ctr. for Ag Safety & Health
Center for Agricultural Business, CSU Fresno
Californa Farm Labor Contractors Alliance
Collaborating Educator Orgs
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State Comp. Ins. Fund
Specialized Safety Training
PAULA Insurance
CA Dept. Forestry & Fire
CV Occup. Medical Group
Cal/OSHA
Western Growers
Proteus, Inc.
Sigerist Consulting
Molina & Associates
Barsamian Saqui & Moody
Beringer Blass Estates
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Stanford University
Cal Poly, SLO
Pac. Northwest Ag S&H
U. of Florida CE
USI Northern CA
UC Cooperative Extensn.
UC Spanish Media Prog.
UC Ag Ergonomics Ctr.
UC Labor Occup. Hlth.
UCSF Med. Ctr.
Western Ctr. for Ag H&S
Cal Policy Resch Ctr.
Cal-Mex. Health Initiative
Practical Adjustments
1. Drinking Water
Before . . . .
After . . . .
A personal "hydration system"
Before . . . .
After . . . .
Before . . . .
After . . . .
2. Shade for Recovery
Other Cooling Devices
RTX Technology
3. Training & Education
Training Aids & References
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Key points handout
UC-CFBF card
Cal/OSHA card
WG card
FLCA card
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FELS video
Proteus flip-charts
LOHP tailgate guide
Cal/OSHA er guide
online refs @ apmp
to request a supply of cards for your employees:
heatstress@cfbf.com or 800-698-3276
More References
http://apmp.berkeley.edu/
The rest of this hour . . .
1. Heat stress physiology 101
2. The new CA regulation
3. RME project in California
4. RME project in Arizona
5. Lessons and unknowns
Envisioned Outcomes
• More workplace training on heat physiology
by the Companies
• Reduced "costs" of access to drinking water
• Increased water consumption to replenish
• Decreased workplace injuries & illnesses
• Decreased business costs
Primary Target Audience
• Farm labor contractors in AZ
• Nursery and Landscaping Industries
• University Experiment Station Workers
• Agri-tourism Industry
Project Activity
• Two Southwest Issues in Agricultural Labor
Workshops in Phoenix and Yuma (2002 and 2003)
• Heat Stress Education in Seminars, Workshops
and Conferences
• Articles in National and Regional Trade Journals
• Handouts and Webpages
• Educational Bookmarks
Workshops and Conferences
Bookmarks and Posters
(2000 copies distributed throughout
Arizona and Nevada)
Website
http://cals.arizona.edu/extension/riskmanagement/index.html
AZ Summary
The rest of this hour . . .
1. Heat stress physiology 101
2. The new CA regulation
3. RME project in California
4. RME project in Arizona
5. Lessons and unknowns
Keys to Effectiveness
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existence of risk with widespread exposure
susceptibility to effective treatment through education
applicable science that had been largely overlooked
investment in understanding science and settings
partnerships within CA infrastructure
flexibility to take advantage of emergent opportunities
sharing ideas, time, materials, and credit with others
multiple channels to deliver and reinforce key points
cases showing dramatic evidence of the problem
regulatory action that heightened receptivity
Unknowns & Unpredictables
• baseline knowledge about heat stress
• heat-related deaths as a labor rallying focus
• adoption of a new workplace regulation
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interpretation and enforcement by Cal/OSHA
adjustments in the regulation
a standard for indoor work?
ultimate impacts on health, safety, production
and indirect costs ???
• coming your way?
Recap
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Heat stress is common in agricultural work
Puts people and business operations at risk
Exercise physiology offers guidance
Principles can be much better applied
New law requires employers to take steps
Emphasis is on water, rest/shade, and education
Important choices to make within the legal bounds
Education helps
The End
. . . extras follow . . .