Heat Illness Prevention Planning
Georgia On-Site Consultation Program
Georgia Tech Research Institute
2013
Do you know the facts?
• Heat stress may result from the buildup of muscle generated heat in the
body.
– True or False?
• The time to drink water is when you are thirsty?
– True or False?
• What are the three most important things you should know about
preventing heat stress?
– A. Water B. Shade C. Rest D. All Three are Important
• The evaporation of sweat is the most important way our bodies get rid of
heat?
– True or False?
• Over 70% of those who suffer a heat stroke die if not treated promptly.
– True or False?
Why Is This Topic Important?
• Heat illness can be a matter of
life and death. Every death is
preventable.
• When heat stroke doesn’t kill
immediately, it can shut down
major body organs causing
acute heart, liver, kidney and
muscle damage, nervous
system problems, and blood
disorders.
• Workers suffering from heat
exhaustion are at greater risk
for accidents, since they are
less alert and can be confused.
• New workers are at increased risk
of injuries.
• Temporary workers often new to
a jobsite
. several times a year.
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Heat Fatalities Map 2009-2012
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August 2012
•
MARK RAINEY, a 60-year-old
temporary worker at an Ohio roofing
company, was working in the hot
summer sun on top of a roof,
throwing roofing material down into
a dump truck. He started to become
lethargic and confused, then lost
consciousness, and died of heat
stroke. He left behind two daughters,
three grandchildren and a large
extended family of aunts, uncles, and
cousins.
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June 2013
• Waste Management of
NJ
• Temp worker fatality
• OSHA cited company
for excessive heat
conditions; lacking rule
on fluid consumption
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A Lucky One
Thank You to Brasfield & Gorrie, LLC for sharing this important video
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OSHA Enforcement: July 2012
1. The employer failed to keep the workplace free of a hazard to which its employees
were exposed:
a. Workers were exposed to a HI at or above the Danger zone (see Hi chart); or
b. Workers were working outside for most of the day or during the heat of the day
when there was a NOAA Heat advisory.
2. The hazard was recognized:
a. NOAA issued heat advisory because of a HI at or above Danger zone (see HI chart)
and employer was or should have been aware of the advisory;
b. Employees made complaints regarding heat;
c. Employees showed signs or symptoms of heat exposure;
d. Employer indicated that it was aware of the heat hazard (e.g., by providing water
but not rest and shade); or
e. The employer’s industry has issued guidance or information about heat hazards.
OSHA Enforcement: July 2012
3.
The hazard was causing or was likely to cause death or serious physical harm:
a. Heat exhaustion;
b. Heat stroke; or
c. Fatality
4. There was a feasible and useful method to correct the hazard:
a. Providing workers with immediate access to water, rest, and shade, and
allowing them to use that relief;
b. Implementing an acclimatization program for new employees and for those
returning from extended time away (e.g., vacation)
c. Implementing a work/rest schedule; or
d. Providing a climate – controlled area to cool down.
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OSHA Enforcement: July 2012
• If all four factors for a general duty clause are
not present, a Hazard Alert Letter (HAL) shall
be issued to the employer as soon as possible.
The HAL shall recommend specific steps the
employer can take to protect workers from
the heat hazard.
Factors That Affect Body’s Ability
to Cool Down
•
•
•
•
•
•
•
•
Age
Weight
Physical Fitness
Adjusting to the hot environment
Other Health Conditions
Use of Alcohol/Drugs/Caffeine
Diuretics
Blood-pressure medications
Medications
Antihistamines
Anti-cholinergics (for COPD)
Psychiatric conditions
Clothing/PPE
What is Heat Stress?
Build of Heat in the body that can not be
removed by natural mechanisms. It is a result
of internal heat generated by the body
(Metabolic Load) and the external heat load
from the work environment.
Types of Heat Stress Disorders
•
•
•
•
Heat Rash (Prickly Heat)
Heat Cramps
Heat Exhaustion
Heat Stroke
• Transient Heat Fatigue
• Fainting (heat syncope)
Behavioral Clues of Heat Stroke
•
•
•
•
Hand/limb shaking
Decreasing productivity through shift
Increased absenteeism
Awkward postures (to compensate for
fatigue)
• Person takes frequent short breaks
First Aid: Heat Stroke
• Call 911 and notify their supervisor.
• Move the sick worker to a cool shaded area.
• Cool the worker using methods such as:
– Soaking their clothes with water
– Remove or open unnecessary clothing
– Spraying, sponging, or showering them with water
while fanning their body
– Apply ice packs to armpits, groin, neck
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CONTROL & PREVENTION
STRATEGIES
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Acclimatization: Gradually Increase
Exposure to Hot Environments
• Workers new to outdoor jobs are generally most at
risk for heat-related illnesses
• Cal/OSHA investigated 25 incidents of heat-related
illness in 2005.
• In almost half of the cases, the worker involved was
on their first day of work and in 80% of the cases
the worker involved had only been on the job for
four or fewer days.
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Acclimatization Physiological
Response
• Sweat Response:
– Less salt in sweat
– Lower core temperature
– Lower heart rate
• Sweating occurs at lower skin temperatures
and total production increases
• = body is better adapted to working in heat
and is less at risk
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General Guideline
• > Work intensity = > Rest periods
• Rest does not mean complete cessation
• Objective is to reduce energy expenditure
Employer Provided Training
Workers need to be trained to know
what to do when a worker has signs
of heat exhaustion:
• Call supervisor
• Stay with worker until help arrives
• Move worker to cooler/shaded area
• Fan and mist the worker with water
• Provide cool drinking water
If the worker feels confused, vomits,
or faints, this may indicate heat stroke
Call 911 immediately!
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The Risk of Heat Stress
Your risk of heat stress depends on
many factors.
These include:
• Your physical condition
• The weather (temperature, humidity)
• How much clothing you have on
• How fast you must move or
• How much weight you must lift
• If you are near a fan or there is a breeze
• If you are in the sun.
•
•
•
•
•
•
•
Heat emergencies
Warning signs of Heat Stroke vary but may include:
an extremely high body temperature (above 103°F, orally)
red, hot, and dry skin (no sweating)
rapid, strong pulse
throbbing headache
dizziness, nausea
disorientation, confusion
unconsciousness
If you see any of these signs, you may be dealing
with a LIFE-THREATENING emergency.
Call 911
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Environment Measures: Heat Index
http://www.osha.gov/SLTC/heatillness/index.html
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Heat Index
Risk
Level
Protective Measures
Less than 91°F
Lower
(Caution)
Basic heat safety and planning
91°F to 103°F
Moderate
Implement precautions and heighten awareness
103°F to 115°F
High
Additional precautions to protect workers
Greater than 115°F
Very High
to
Triggers even more aggressive protective
Extreme
measures
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Heat Index Risk Level
Lower
Plan Element
Supplies (ensuring adequate water,
provisions for rest areas, and other
supplies)
(Caution)
Moderate
High
Very
High/Ext
reme
Emergency planning and
response (preparing supervisors
and crews for emergencies)
Worker acclimatization (gradually
increasing workloads; allowing
more frequent breaks as workers
adapt
to the
heat)
Modified
work
schedules
(establishing systems to enable
adjustments to work schedules)
Training (preparing workers to
recognize heat-related illness and
preventive measures)
Physiological, visual, and verbal
monitoring (using direct
observation and physiological
monitoring to check for signs of
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Heat Index Additional Risk Factors
• Work in direct sunlight
• Perform prolonged or
strenuous work
• Wear heavy protective
clothing or
impermeable suits
• These must be taken
into consideration even
when the heat index is
lower.
• Since heat index values
were devised for shady,
light wind conditions,
exposure to full
sunshine can increase
heat index values by up
to 15°F. Also, strong
winds, particularly with
very hot, dry air, can be
extremely hazardous.
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RESPONSIBILITY
Staffing
Host
Employer Agency
Fatality Assessment and Control
Evaluation Program (FACE)
Case Study(s)
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FACE REPORT
Fatality Assessment and Control Evaluation Program
FACE REPORT #1
FACTS:
• 31-year-old male
concrete construction
laborer dies of heat
stroke at end of work
day
• Temperature was 88
degrees
• After reporting he felt ill, his
foreman instructed him to
lie in the shade beneath a
tree
• He remained in the shade
for 10 minutes, returned to
work and was observed
staggering, speaking
incoherently, and stumbling
through freshly poured
concrete
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FACE REPORT
(Fatality Assessment and Control Evaluation Program)
FACE REPORT #2
FACTS:
• 41-year-old male
laborer died from heat
stroke at end of work
day
• Temperature was 90
degrees; dew point
humidity 69 degrees
(relative humidity 50%)
• Employee (a welder), had spent
the day cutting 2x4’s to varying
lengths to fabricate forms for
concrete footers
• His internal temperature was 108
degrees F.
FACE
Fatality Assessment and Control Evaluation Program
FACE REPORT #3
FACTS
• 30-year-old male landscape
mowing assistant dies from heat
stroke at end of work day
• He was part of a 2-person crew
• He had reported feeling lightheaded and short-of-breath to his
partner in the mid-afternoon
• Outdoor temperature was 81
degrees
• Victim’s internal temperature
was 107.6 degrees at the hospital
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