Heat Stress · 2018-07-03 · Heat disorder is a general term used to describe the stresses associated with excessive heat exposure

Dangers

Prevention

Treatment

Heat Stress

2018 MiCAH Safety Solutions, LLC

Employee Training- OSHA

Review heat-related illness signs and symptoms and site-specific precautions during daily meetings and toolbox talks.

Make sure everyone is trained on: How to recognize heat-related illness How to prevent it First aid (treatment) Risk factors How to contact emergency medical services


Defining the Problem

Heat disorder is a general term used to describe the stresses associated with excessive heat exposure.

Heat stress is the stress incurred on the body when environmental and/or physical factors prevent the transfer of excess body heat.

Metabolic rate (body heat) is the body heat generated by the bodys own internal functioning. Metabolic rate increases as the workload heat exposure increases.


Fatal NumbersFar too many workers die from heat stress related events every year according to the Bureau of Labor Statistics.

It CAN happen to you


United States Fatalities

According to the CDC, there were 3,442 fatalities between 1999-2003

Approximate average of 690 deaths per year

The largest percentage being male and the elderly

Age can be a major factor


In the Workplace

According to OSHA, dozens of workers die and thousands more become ill while working in extreme heat or humid conditions every year.

More than 40 percent of heat-related worker deaths occur in the construction industry, but workers in every field are susceptible.

There are a range of heat illnesses and they can affect anyone, regardless of age or physical condition.


The Bodys Response to Heat


The human body naturally tries to maintain a constant internal temperature.

When the internal temperature rises, the body attempts to get rid of excess heat by:

1.Increasing blood flow to skin surface2.Releasing sweat onto skin surface

Effects of the Bodys Response


Reduced blood flow to brain Reduced mental alertness

and comprehension Reduced blood flow to active

muscles Fatigue, loss of strength Increased sweating Slipperiness

Cooling Mechanism Failures


High temperature reduces effectiveness of the cooling system

High humidity reduces the evaporation rate of sweat

Excessive loss of sodium

Dehydration begins to take place

Dehydration

Cause: Excessive fluid loss

Signs & symptoms: Fatigue, weakness, dry mouth

Treatment: Fluids and salt replacement


Heat Rash


Cause: Inflamed skin

Signs & Symptoms: Rash with pink pimples, itching, tingling

Treatment: Cleanse area and dry, apply calamine or other approved lotions

Heat Cramps

1. Intermittent, involuntary spasms of larger muscles that occur in an individual who is physically active in hot weather

2. Severe Cramps, Rigid Muscles3. Usually Begin in Hands and

Feet (also legs and abdomen) 4. Profuse sweating


Heat Exhaustion

1. Fatigue, Headache, Nausea2. Excessive Thirst3. Cramps, Weakness4. Confusion or Anxiety5. Profuse Sweating 6. Cold Clammy Skin7. Slowed or Weakened Heartbeat8. Dizziness, Fainting, Agitation


Heat Stroke1. Nausea, Vomiting, Headache2. Dizziness, Vertigo3. Hot Flushed Skin4. Rapid Heartbeat5. Decreased or Ceased Sweating6. Shortness of Breath7. Decreased or Bloody Urination8. Increased Body Temperature-

(104-106)9. Confusion or Delirium10.Loss of Consciousness11.Convulsions


Heat Exhaustion vs. Heat Stroke

Heat Exhaustion:1. Fatigue, Headache, Nausea2. Excessive Thirst3. Cramps, Weakness4. Confusion or Anxiety5. Profuse Sweating 6. Cold Clammy Skin7. Slowed or Weakened Heartbeat8. Dizziness, Fainting, Agitation

*Notice the Differences in Red

Heat Stroke:1. Nausea, Vomiting, Headache2. Dizziness, Vertigo3. Hot Flushed Skin4. Rapid Heartbeat5. Decreased or Ceased Sweating6. Shortness of Breath7. Decreased or Bloody Urination8. Increased Body Temperature-

(104-106)9. Confusion or Delirium10.Loss of Consciousness11.Convulsions


Heat Stroke vs. Heat Exhaustion


The differences are notable

and extremely important.

Environmental/Atmospheric Factors


1. Air Temperature

2. Humidity

3. Radiant Heat Source

4. Air Circulation

Heat Illness- Contributing Factors

Some risk factors that may contribute to or accelerate Heat Illness are:

Elderly and obese people are at a higher risk. Employees that have experienced a heat related event in the past. Employees that have been or are sick have a diminished tolerance and may need

additional breaks. Medications, such as diuretics (water pill) and neuroleptics (Xanax), more Alcohol Use Heart Disease, high blood pressure, kidney or liver, respiratory problems Sweat gland problems


The Quick and the Dead

If the problem isn't addressed heat cramps can quickly lead to heat exhaustion, which can easily progress to heatstroke.

Heatstroke, the most serious of the three heat injuries can cause shock, brain damage, organ failure, and even death.


Are You Hydrated?


If you notice your urine to be dark according to the chart, measures need to be taken to adequately increase your hydration levels.

Prevention- Proper Hydration


Drink plenty of fluids: 8 ounces every 20 minutes

Dont rely on your thirst Eat proper meals: several fruits

and vegetables have hydrating properties

Getting plenty of sleep also helps

No Caffeine

Caffeine can contribute to dehydration and should be avoided while working during high or extreme temperatures.


No Alcohol

Alcohol greatly increases the risk of dehydration.

Either refrain from alcohol consumption or drink little during times of elevated heat dangers.

Gatorade or H2O???

Water is the recommended fluid to drink regularly and consistently.

Sports drinks are recommended as a supplement to water.

Sports drinks do provide possible depleted electrolytes.

Do remember that some sports drinks contain high levels of sugar.


PresenterPresentation NotesThe WaterBoy may have been wrong about why alligators had so many teeth, but he was right about the H2O. Dont upset the WaterBoy!

Prevention- Acclimatization

Acclimatization: adjust to the heat

The body takes 3-5 days to get used to the heat

Be careful when returning from a change in routine: (i.e. vacation or time away from the heat)

Take it slow for a few days and allow your body to adjust


Prevention- What You Wear

Choose proper clothing: Wear light colors if working

outside Wear lightweight/breathable

material Avoid long sleeves, coveralls and

jackets if possible


Work Related Factors

The following factors can contribute to Heat Stress Illness and require special consideration, monitoring and precautions:

Workload (amount of work) Type of work Level of physical activity Duration (amount of time) spent working Personal protective equipment and clothing Weight (heavy or non-breathable vs. breathable)


Work Activity Controls

Try to schedule high burden and strenuous activities during the early hours of the morning to avoid the intense midday sun and heat.

Adjust crew complements in order to allow for sufficient rest and cool down breaks.

Rotate workers in extreme heat if possible.

Use work/rest cycles to give your body time to recover.

More controls will be listed as we go along. [See Recommended Precautions]


Find or Create a Good Place to get Out of Direct Sunlight


Cooling Down


Rest in the shade when you need to cool down.

When resting have a well ventilated area or have a fan blowing to circulate air.

A useful tool is to pour small amounts of water on the back of the neck or apply a cool cloth to back of neck.

When working indoors in extreme heat, have a cool room.

Portable AC units are very helpful and effective.

Portable Cooling Options


Why Sunscreen is Important?

Sunburn reduces the skin's ability to release excess heat, making the body more susceptible to heat-related illness.

Wear sunscreen and use other protections from direct sunlight.

Shade and hats are also important for this reason.


Nobody Knows Your Body

Like You Do


Radiant heat is the transfer of heat energy without direct contact. Radiant heat sources are the sun or any other object that has been heated or projects heat.

Radiant heat shielding materials can be used to block/shield the heat transfer from hot surfaces by using insulation or reflective screens.

Radiant Heat


As Cool As The Other Side Of The Pillow

There are 3 preferred types of cool vests on the market:

1. Vests that utilize ice 2. Circulate a cool fluid 3. Those that use air with an in-line

vortex tube.

Okay, maybe not that cool, but Cool Vests can greatly help in extreme heat environments.


Extremely Cool

Aluminized full body suits the external aluminized material blocks and reflects the radiant heat.

Circulating air suits work like the air vest with the in-line vortex except with full body coverage.

Respiratory protection with in-line air cooling vortex tubes used along with an airline respirator for temperatures of 150F or higher.


Heat Stress Plan Development

When working in elevated heat stress environments a Plan should be developed.

The first step in developing a Heat Stress Plan is to determine the heat stress work by identifying the work rate on the table on the next slide.

Record it on a document similar to the one in this presentation:


Approximate Metabolic

Work Rates

Appendix ATable


Work/Rest Cycle Guidelines

The following work/rest cycles are guidelines published by the American Conference of Governmental Industrial Hygienists (ACGIH). They can be modified when controls involving cooling equipment are implemented.

These guidelines are no substitute for proper supervision, worker awareness and common sense. Employees exhibiting signs of heat related illness while working under these guidelines should be moved to a cool area and the work/rest cycle may be modified.


Work/Rest Cycle Recommendations- ACGIH

The work/rest cycles contained in the table on the following slide can be used to determine the workload per hour of employees.

To use this table, a wet bulb, dry bulb and globe temperature (WBGT) monitor will be needed.

Decide upon what level of work is to be done (see Appendix A Table). Based on the workload and the WBGT reading, the percent recommended work/rest is listed.

See the following slide:


Work/Rest Cycle Recommendations

Work / Rest Cycles Work Load Categories

Light Moderate Heavy Very Heavy

75-100% Work / 0-25% Rest 88 F WBGT 82 F WBGT NA* NA*

50-75% Work / 25-50% Rest 88 F WBGT 84 F WBGT 82 F WBGT NA*

25-50% Work / 50-75% Rest 90 F WBGT 86 F WBGT 84 F WBGT 82 F WBGT

0-25% Work / 75-100% Rest 91 F WBGT 87 F WBGT 87 F WBGT 86 F WBGT

* Not available - safe limits are not defined for these categories


Heat Index Chart

The table on the next slide can be used to determine the temperature and humidity in the work area.

These values are based on an individual wearing the right amount and type of clothing, doing light work, with little wind.

Increased workloads will result in higher values. All work in temperatures of 150F or higher require specific respiratory protection and other control measures.

Note: Exposure to direct sunlight can increase Heat Index values by up to 15 F.

See the Table on the next slide:


Site-Specific Heat Stress

Plan

Project Location Date Superintendent Work Scope Work Location Clothing Personal Protective Equipment (Refer to Section 5.3)

Temperature Relative Humidity Heat Index (Refer to Section 6.3) Work Rate (Refer to Section 6.1 and Circle One) Light Moderate Heavy Work Rest Cycle (Refer to Section 6.2) Administrative Controls (Refer to Section 5.1)

Engineering Controls (Refer to Section 5.2)

This plan is provided as a

guide for needed information in a

site-specific plan.


Project

Location

Date

Superintendent

Work Scope

Work Location

Clothing

Personal Protective Equipment

(Refer to Section 5.3)

Temperature

Relative Humidity

Heat Index (Refer to Section 6.3)

Work Rate (Refer to Section 6.1 and Circle One)

LightModerateHeavy

Work Rest Cycle (Refer to Section 6.2)

Administrative Controls


Engineering Controls


Wet Bulb Globe Temperature (WBGT)

The WBGT takes into account the ambient temperature, the humidity and the effect of radiant heat.

Globe temperature is the temperature measurement that takes the effects of radiant heat and convection (wind or a draft) into consideration.

Wet bulb globe temperature (WBGT) is an index of environmental heat stresses based upon three temperature measurements (wet bulb, dry bulb and globe). WBGT measurements are in units of degrees Fahrenheit (F).

Wet bulb temperature is the temperature measure that takes into consideration the effects of water evaporation. This temperature is inversely proportional to heat exchange by evaporation.

2018 MiCAH Safety Solutions, LLC WBGT Monitor

OSHA/NIOSH Heat Safety Tool App


The free App allows workers and supervisors to calculate the heat index for their worksite, and based on the heat index, displays a risk level for outdoor workers.

Log on to osha.gov or visit your app store to download the app on your Smartphone.

Look at the following slides for the recommendations according to the Heat Safety Tool.

Recommended Precautions


When the Heat Index reaches 91-103: Moderate Risk ConsiderationsWhen the Heat Index reaches 104-115: High Risk ConsiderationsWhen Heat Index levels are above 116: Very High to Extreme Risk

According to the OSHA/NIOSH Heat Safety Tool some Recommended Precautions are the same, but some are very different depending on the calculated risk. They are listed for each category on the App.

They include the following: Condition Descriptions and WarningsWater and Shade RecommendationsEmergency Planning and ResponseWork and Rest, and more



For All 3 Categories- Moderate, High and Very High to Extreme Risk:

Adequate amounts of drinking water must be in convenient, visible locations close to the work area.

Drink plenty of water, even if youre not thirsty. If in the heat less than 2 hours and involved in moderate work activities, drink 1

cup (8 oz.) of water every 15 to 20 minutes. During prolonged sweating lasting several hours, drink sports drinks containing

balanced electrolytes. Generally, fluid intake should not exceed 6 cups per hour. Set up cool, shaded rest areas and schedule frequent breaks. Provide shade, hats, and sunscreen, and encourage their use.



For All 3 Categories

Emergency Planning and Response:

Check weather forecast regularly and make sure plans are in place before hot outdoor work begins.

Make sure medical help (clinic, hospital, emergency services) is nearbyif not, first aid must be performed on site.

Appropriately trained personnel and adequate medical supplies need to be available.

Know where you are in case you need to call 911.

Know the Difference

The following slides will explain the differences in recommended precautions

for High or Very High to Extreme Risk considerations as noted by OSHA/NIOSH.




When the Heat Index reaches 104-115, High Risk Considerations:

Work practices considered to be High Burden should be actively managed. Those activities may include but are not limited to:

Work requiring the use of FR clothing and rubber gloves and sleevesWork in confined/enclosed spacesWork taking place in direct sunlightA recommendation of a 10 minute break during every hour of work in

these types of conditions should be considered.



When Heat Index levels are above 116, Very High to Extreme Risk:

Reschedule all non-essential work for days when the heat index is lower. Move essential work to the coolest part of the day start earlier, split the work shift, or work evening/night shifts.

Strenuous tasks and those requiring the use of heavy or non-breathable clothing or impermeable chemical protective clothing should not be conducted (if possible).

If emergency or essential work must be done at this heat index, then a designated knowledgeable person should be on-site to modify work activities and set work/rest schedules. STOP WORK if protective measures are not possible.

For emergency work and essential work that cannot be rescheduled, review the next slide:


When Heat Index levels are above 116, Very High to Extreme Risk:

When heat index levels are above 116, management should give consideration to suspending high burden work activities.

If work activities must take place in these extreme conditions, it is recommended to take a 10 minute break for every 30 minutes of work.

Breaks should take place in a air-conditioned building or vehicle and employees should be closely monitored for signs and symptoms of heat illness.

Establish a clear drinking schedule.Actively encourage workers to drink water often.



When Heat Index levels reach High or Very High to Extreme Risk:

Acclimatize new and returning workers. These individuals are at higher risk for heat-related illness. Closely supervise unacclimated workers.

Establish and follow a work/rest schedule. Take into account the level of exertion and type of personal equipment used.

Supervisors should enforce rest breaks in cool, shaded areas. Remove protective clothing (if possible) while resting. Increase rest time as heat index rises or if workers show signs of

heat-related illness.2018 MiCAH Safety Solutions, LLC


Adjust work activities.Do strenuous tasks earlier in the day.Where possible, set up shade canopies over work areas. Permit only acclimatized workers to perform more strenuous tasks.Decrease the pace of strenuous job tasks. Look for other ways to adjust work activities (add more workers,

rotate jobs) See very high to extreme risk precautions if working in direct sun.




If wearing heavy or non-breathable clothing or impermeable chemical protective clothing, these additional precautions are needed:

Reschedule activities for when the heat index is lower (morning, evening, different day).

Modify work/rest schedules to accommodate those wearing protective clothing. Physiologically monitor workers (e.g., body temperature, heart rate). Rotate workers to tasks that do not require protective clothing for part of the

shift. Encourage removal of protective clothing when on rest breaks, when possible. Provide personal cooling measures (e.g., water-dampened clothing, cooling

vests, misting or cooling stations).




Emergency Planning and Response (remember, these are in addition to the precautions already listed for all 3 categories):

Alert workers to the high or very high to extreme heat index and identify all precautions in place at the work site.

Call 911 and cool a worker who is unconscious, confused, or uncoordinated. This may be heat stroke, a medical emergency.



When Heat Index levels reach Very High to Extreme Risk:

Emergency Planning and Response

Have a knowledgeable person on site to not only determine work/rest schedule but also to conduct physiological monitoring.


Heat Index- Quick Reference Table

This table provides a quick reference guide for the purpose of awareness, and is good to post in visible locations.

Refer to the recommended guidelines for proper details.

May vary by 1 degree


Buddy System and Supervisors

Set up a buddy system to enable workers to look out for signs and symptoms of heat-related illness in each other.

Keep an eye on your coworkers.

Supervisors should routinely check on workers and encourage water and rest breaks.


Heat Illness-Treatment

Heat Cramps Move to a Cool Environment Rest Drink Water, Salty Drinks, Sports Drink Replenish Salt and Electrolytes Massage Cramps If No Change in 1 Hour Seek Medical

Assistance STOP at First Symptoms



Heat Exhaustion Call for Emergency Medical Assistance Move to a Cool Environment Drink Fluids if Possible Do not Force Fluids if Confused or

Unconscious Replenish Salt and Electrolytes Lie Flat with Feet Slightly Elevated



Heat Stroke Medical Assistance Immediately Call 911 IMMEDIATELY! Move to Cool Environment Wrap in Cool, Wet Dressings Sponge Body with Cool Water Ice Packs in Groin, Neck, Arm Pits Blow Cool Air on Person Monitor Temperature Monitor Vital Signs Move to Hospital ASAP


Recognize and Expect Confusion

Heat illness can make the worker confused, resistant to

help and even combative.

Try to calm them, explain to them what is going on and

assure them they will be okay.


Other Factors to Consider


Good employees want to get-the-job done, sometimes too much so.

Slow down in heat, pace yourself.

Mechanical assistance using machines or equipment helps to reduce the physical exertion of the worker and aids in keeping the body temperature down.

Easier to Make Mistakes


It can be easier to make mistakes or be injured when working in extreme heat due to:

Difficulty in concentrating Easier to be frustrated Short tempers Slippery hands Hot surfaces, tools and equipment Sweat getting in eyes

Pre-Job Briefings

Discuss the heat stress hazards and precautions during the pre-job briefing.

List the steps on your pre-job briefing document.


Post- Incident

The occurrence of a heat related illness may indicate a need to re-evaluate exposure times and control measures. Additional monitoring of the workforce and environment may also be necessary.

Once the event has passed, hold a job briefing with all supervisors and workers, and discuss what went wrong and what measures are to be followed going forward.


Prevention Review

1. Dress in loose, light weight, and light colored clothing2. Refrain from alcohol and caffeine consumption during high temperatures3. Get plenty of rest when not working, and eat a good diet 4. Stay hydrated; drink plenty of water and drinks that contain salt and

electrolytes5. Stay out of heat as much as possible6. Know and monitor the symptoms of Heat Illness (No One Knows Your

Body Like You)


Prevention Review7. STOP if uncertain at all about symptoms8. Take plenty of breaks in a cool environment9. Use cool vests if needed in extreme heat environments10.Watch out for each other; supervisors watch your workers for signs and

following preventative measures11.Use engineering controls when possible; such as cool rooms, fans, etc.12.Follow the heat index and work/rest cycle guidelines


*Never, Ever Continue to Work when Experiencing Symptoms of Heat Illness.Once You Have Reached Extreme Symptoms It May Be Too Late!

Dont Let This Happen To You2018 MiCAH Safety Solutions, LLC

Copyright All information developed and produced by MiCAH Safety Solutions, LLC is proprietary, and cannot be reproduced, transmitted, or redistributed without the expressed written consent of MiCAH Safety Solutions, LLC.

All Rights Reserved.

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Slide Number 1Employee Training- OSHASlide Number 3Fatal NumbersUnited States FatalitiesIn the Workplace The Bodys Response to Heat Effects of the Bodys Response Cooling Mechanism FailuresDehydrationHeat RashHeat CrampsHeat ExhaustionHeat StrokeHeat Exhaustion vs. Heat StrokeHeat Stroke vs. Heat ExhaustionEnvironmental/Atmospheric FactorsSlide Number 18The Quick and the DeadAre You Hydrated?Prevention- Proper HydrationNo CaffeineSlide Number 23Gatorade or H2O???Prevention- AcclimatizationPrevention- What You WearWork Related Factors Work Activity ControlsFind or Create a Good Place to get Out of Direct SunlightCooling DownPortable Cooling Options Why Sunscreen is Important?Nobody Knows Your Body Like You DoSlide Number 34As Cool As The Other Side Of The PillowExtremely CoolHeat Stress Plan DevelopmentApproximate Metabolic Work RatesWork/Rest Cycle GuidelinesWork/Rest Cycle Recommendations- ACGIHWork/Rest Cycle RecommendationsHeat Index ChartSlide Number 43Site-Specific Heat Stress PlanWet Bulb Globe Temperature (WBGT)OSHA/NIOSH Heat Safety Tool AppRecommended PrecautionsRecommended PrecautionsRecommended PrecautionsKnow the DifferenceRecommended PrecautionsRecommended PrecautionsRecommended PrecautionsRecommended PrecautionsRecommended PrecautionsSlide Number 56Recommended PrecautionsRecommended PrecautionsHeat Index- Quick Reference TableBuddy System and SupervisorsHeat Illness- TreatmentHeat Illness- TreatmentHeat Illness- TreatmentRecognize and Expect ConfusionOther Factors to ConsiderEasier to Make Mistakes Pre-Job BriefingsPost- Incident Slide Number 69Slide Number 70Dont Let This Happen To YouCopyright

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Heat Stress · 2018-07-03 · Heat disorder is a general term used to describe the stresses associated with excessive heat exposure