HEAT STRESS 1

OSHA does not have a specific heat stress standard, OSHA relies on Section 5(a)(1) of the Occupational Safety and Health Act of 1970 (OSH Act) (also known as the General Duty Clause) to require employers to provide a safe and healthy environment for all workers and recommends that employers, implement policies to address working during hot weather conditions. 2

 Between 1979 and 2013, the death rate as a direct result of exposure to heat (underlying cause of death) generally hovered around 0.5 deaths per million population, with spikes in certain years.  Overall, a total of more than 9,000 Americans suffered heat-related deaths since  This number does not capture the full extent of heat-related deaths for several reasons… 3

U.S. HEAT STROKE STATS  At least 300 deaths/year  1700 deaths in 1980 alone  Causes more deaths annually than hurricanes, lightning, tornadoes, floods, and earthquakes combined  18 high school and college football player deaths since

HEAT RELATED DEATHS  Korey Stringer –27 Yrs Old6’3”335 lbs  Eraste Autin –18 Yrs Old6’2”250 lbs  Preston Birdsong –18 Yrs Old5’11”190 lbs 5

COMMON FACTORS (Worker vs. Athlete)  Protective clothing  Focus on task at hand  Job security concerns  Desire to succeed  Desire to be accepted  Machismo  Peer pressure  Delayed thirst mechanism 6

PHYSIOLOGICAL RESPONSES TO OVERHEATING English Translation: What happens when you get too dang hot 7

“TOO DANG HOT RESULTS”  Excessive sweat loss results in dehydration  Results in loss of electolytes  The body loses its ability to cool  Increased blood flow to skin causes decrease in organ function 8

HEAT-RELATED ILLNESSES  HEAT CRAMPS  HEAT EXHAUSTION  HEAT STROKE  HEAT COLLAPSE  HEAT RASH  HEAT FATIGUE 9

HEAT CRAMPS  Caused by excessive loss of electrolytes  Early warning sign of heat stress  Painful cramps usually in legs or abdomen  Stop activity, hydrate, rest in cool place  Get medical attention if condition continues 10

HEAT EXHAUSTION  The body’s response to excessive water and electrolyte loss  Stop activity and seek treatment immediately 11

HEAT STROKE  The body’s cooling mechanism shuts down  50% that reach the heat stroke stage die even with medical attention 12

Heat Collapse ("Fainting")  The brain does not receive enough oxygen because blood pools in the extremities.  As a result, the exposed individual may lose consciousness.  This reaction is similar to that of heat exhaustion and does not affect the body's heat balance. However, the onset of heat collapse is rapid and unpredictable.  To prevent heat collapse, the worker should gradually become acclimatized to the hot environment. 13

Heat Rash  The most common problem in hot work environments.  Prickly heat is manifested as red papules and usually appears in areas where the clothing is restrictive.  As sweating increases, these papules give rise to a prickling sensation.  Prickly heat occurs in skin that is persistently wetted by unevaporated sweat, and heat rash papules may become infected if they are not treated.  In most cases, heat rashes will disappear when the affected individual returns to a cool environment 14

Heat Fatigue  A factor that predisposes an individual to heat fatigue is lack of acclimatization.  The use of a program of acclimatization and training for work in hot environments is advisable.  The signs and symptoms of heat fatigue include impaired performance of skilled sensory-motor, mental, or vigilance jobs.  There is no treatment for heat fatigue except to remove the heat stress before a more serious heat- related condition develops 15

LIVE OR DIE? HEAT EXHAUSTION  Skin is pale  Excessive sweating  May faint but usually conscious  Headache  Nausea and vomiting  Blurred vision  Dizziness HEAT STROKE  Skin is red  No sweating  Unconscious or incoherent 16

TREATMENT HEAT EXHAUSTION  Call 911  Rest in cool place  Loosen and remove unnecessary clothing  Shower or sponge with cool water HEAT STROKE  Call 911  Immediate, aggressive, effective cooling  DO NOT give anything by mouth  Transport to hospital 17

HUMAN RISK FACTORS  Poor nutrition  Poor physical condition  High and low % body fat  Previous heat illness  Lack of acclimatization  Over 40  Illness (diabetes, asthma)  Pregnancy  Diet plans  Medications  Allergy medicines (antihistamines)  Some blood pressure and heart medicines (beta-blockers and vasoconstrictors)  Diet pills and illegal drugs such as cocaine (amphetamines)  Laxatives  Some medicines that treat mental health conditions (antidepressants and antipsychotics)  Seizure medicines (anticonvulsants)  Water pills (diuretics) 18

ENVIRONMENTAL RISK FACTORS  Air temperature  Direct sunlight  Radiant heat  Humidity  Little air movement 19

JOB RISK FACTORS  Work intensity  Work duration  Location (roof, road, enclosure)  Clothing (weight, impermeability)  Respiratory protection 20

WORKER RESPONSIBILITY  Follow instructions of IH and health care professionals  Be watchful for symptoms (self and others)  Properly hydrate (before, during, after)  Get adequate rest  Avoid alcohol, unnecessary medication, and caffeine 21

MANAGEMENT RESPONSIBILITY  Ensure that environmental conditions are monitored  Adjust work practices as necessary  Be watchful for signs of overexposure  Know workers medical history  Assure workers are properly trained  Conduct pre and post job safety meetings  Assure that affected workers receive treatment 22

MONITORING  Environmental monitoring –WBGT (heat index= temp+humidity+radiant) used for guidance in establishing work/rest ratio  Personnel monitoring –Oral thermometer –Ear probe –R*&%$! Thermometer –Core Temp –Pulse rate –Blood pressure 23

COOLING WEAR  Traditional ice vests  Chem-pack vests, headbands, & bandanas  Active cooling garment (water circulating)  SAR and PAPR with active cooling systems  New material development (breathable, lighter weight, waterproof) 24

NOAA Heat Index 25

* Acute problem resulting from prolonged cold exposure and heat loss * “Hypo” (too little) “Thermia” (heat) * 750 deaths/year in USA * Generally doesn’t present the same level of danger as heat stress * Does not occur as quickly * Workers will simply come in out of the cold

* Cold Temperatures * 41 degrees F is cold enough with other contributing factors * Improper clothing and equipment * Wetness * Sweating, contact with water * Water conducts heat away from the body 25 Xs faster than air

* Fatigue * Dehydration * Hunger * Alcohol intake

* SYSTEMIC * Hypothermia * LOCALIZED * Frostnip * Frostbite * Trench Foot

* Hypothermia * Body temp <95 degrees F * Euphoria * Slow weak pulse * Slurred speech * Shivering * Unconsciousness

* Frostnip/Frostbite * Itching/burning/numb * Skin color change * White * Grayish yellow * Reddish violet * Black * Trench Foot * Severe pain/itch/tingle * Swelling * Blisters

* Hypothermia * Move to warm area * Remove wet clothing * Modest external warming * Blankets/heat packs * Drink warm sweet fluids (non- caffeinated) * Transport to hospital * Frostnip/Frostbite * Move to warm area * External warming * Warm water * Drink warm sweet fluids (non- caffeinated) * Treat as burn (do not rub) * Transport to hospital

* Vasoconstriction * Blood vessel constriction * Reduces heat loss/makes skin better insulator * Shivering * Increases body temp as vasoconstriction fails * **NEITHER ARE AS EFFECTIVE AS SWEATING AND ACCLIMATION ARE FOR HEAT STRESS

* Behavior is the primary protection factor for cold stress prevention * Increase clothing insulation * Increase activity * Seek warm location * Get the H$!! out of there

* Engineering Controls- Warming shelters, spot heating (i.e. hand warmers), minimize air movement (shielding) * Work Practices- fluid replacement, change wet clothes immediately, buddy system * Administration Controls-work/rest cycles, warm period work, allow for productivity reductions * PPE

* Dress in Layers * Add or remove for comfort * Allows free movement and dexterity * Layer closest to skin should be “water vapor permeable” * Wicks away moisture, allows evaporation, prevents accumulation

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39 * LEARN CPR AND FIRST AID * ACCIDENTS ARE PREVENTABLE * WATCH YOUR FAMILY AND FRIENDS * TEAMWORK SAVES PAPERWORK