Workplace Heat Illness Prevention SU Office of Environmental Health & Safety Occupational Health & Safety Program x3-0448 4/15

Outline Heat illness Prevention of heat illness Risk factors How the body handles heat Types of heat illness Prevention of heat illness Water consumption, shade, and cool-down rests Importance of acclimatization Emergency response procedures Supervisor guidelines

Cal/OSHA Standard 8 CCR 3395- Heat Illness Prevention Applies to outdoor places of employment with heat illness potential Requirements Heat illness prevention training for supervisors and employees Local procedures for heat illness prevention

Heat Illness

Risk Factors for Heat Illness Weather conditions Higher temperatures Higher humidity Air movement High radiant heat (e.g. sunshine) High conductive heat (e.g. ground) Higher intensity and/or duration of physical activity PPE/ clothing can be a factor (i.e., tyvek coveralls) More air movement reduces risk when < 95°F, increases risk when > 95°F Higher intensity and/or duration of physical activity= physical activity generates additional body heat

Personal Risk Factors Poor physical condition* Older age Degree of acclimatization Low water consumption Some medications* Use of alcohol/ drugs * Recommend checking w/ personal physician about heat illness risk Overweight– extra weight requires = more energy spent to work & reduces ability to release heat Age– sweat gland response decreases w/ age Alcohol/ some drugs– body dehydrates much quicker * Recommend consulting with personal physician to check if condition(s) may increase risk for heat illness.

How the Body Handles Heat The body tries to keep a constant internal temperature As internal temperature rises from activity, the body cools itself by: Increasing blood flow to skin surface Releasing sweat onto skin surface When the body can no longer cool off, mild symptoms of heat illness can quickly turn serious and life-threatening Blood flow can cool internal body temperature, but doesn’t work well when outside air temp is warmer than body Sweating is next step– but this will not work well w/ high humidity So, heat illness risk is highest w/ extreme heat & humidity!

Heat Exhaustion Cause: Signs & Symptoms: Excessive loss of water and salt through sweat Signs & Symptoms: Headaches, dizziness, lightheadedness or fainting Weakness and moist skin Muscle cramps Mood changes such as irritability or confusion Upset stomach or vomiting Heat exhaustion is caused by the loss of large amounts of fluid through sweating, often accompanied by excessive loss of salt. Unlike heat stroke, someone suffering from heat exhaustion still is sweating heavily. Skin will be pale and cool. The symptoms of heat exhaustion may resemble some of the early signs of heat stroke.

Treat as a medical emergency! Can be life threatening. Heat Stroke Cause: Total breakdown of body’s cooling system Signs & Symptoms: Sweating stops-- skin is hot, red, and dry Mental confusion, losing consciousness Fainting Seizures or convulsions Treat as a medical emergency! Can be life threatening. Heat stroke is the most serious of the heat stress disorders. Is a total breakdown of your body’s cooling system. Pumping blood to the skin surface and sweating becomes inadequate and your body temperature rises to potentially fatal levels.

Emergency Response Procedures For any of the previously mentioned symptoms: If first-aid trained personnel are not available on-site to provide assessment, immediately call 911 or 9-911 (from a campus phone) OR transport to Stanford Hospital Emergency Room While waiting for help: Move victim to cool area Give small cup of water (if conscious and not nauseous) Loosen and/or remove clothing Fan and mist the person w/ water Apply a water-soaked towel (or ice pack wrapped in towel) to head and ice pack to armpits Contact supervisor immediately Anyone with symptoms must never be sent home or left unattended without a medical evaluation SU Occupational Health Center follow-up for employees evaluated for heat illness Remember, early recognition of heat stroke is the only means to prevent death. Until help arrives, provide the first aid described.

Prevention of Heat Illness

Stay hydrated: Don’t forget to drink! Employees shall be provided enough cool, fresh drinking water for all work hours. Recommend drinking at least four cups per hour for the entire shift.

Cool down in the shade When warmer than 80°F, a shaded rest area shall be provided at or nearby the work area. When < 80°F , shade shall be provided upon employee request. Whenever needed, take a cool-down rest in the shade to help prevent overheating. Tell your supervisor if you feel symptoms of heat illness Take at least 5 minutes to rest in the shade Do not return to work until symptoms have gone away Example shaded areas: Buildings, building or vegetation shadows (if large enough), shade tents, vehicles with air conditioning. Where symptoms of heat illness are reported, trained first-aid personnel shall assess the employee. If trained first-aid personnel are not immediately available, follow emergency response procedures.

Supervisor Guidance

Work Planning and Supervision Assess conditions Weather forecasts - http://nws.noaa.gov Current weather - http://weather.stanford.edu * Note: high humidity drives up the heat load For warmer periods: Schedule outdoor work during cooler parts of the day For most strenuous tasks, plan a staff rotation Advise staff to wear lighter, loose-fitting clothing and wide brimmed hats

Work Planning and Supervision Worker acclimatization People adapt to weather changes within 4-14 days. To minimize the risk of heat illness: Employees shall be closely monitored by supervisor/designee during a heat wave* For new employees and those returning from extended leave/ illness, closely monitor them for 14 days by: Directly observing them, or Having a mandatory buddy system *Cal/OSHA defines heat wave as temperatures of 80 degrees F or warmer and at least 10 degrees F warmer than the average daytime temperature of the previous 5 days *Cal/OSHA defines heat wave as temperatures of 80 degrees F or warmer and at least 10 degrees F warmer than the average daytime temperature of the previous 5 days

Work Planning and Supervision For outdoor temperatures ≥ 80°F, supervisors shall: Provide shade at/ nearby worksite for employee rest breaks. If not safe or feasible to provide shade, alternative cooling measures with equivalent protection are required. Encourage staff to take cool-down rests in the shade as needed to avoid overheating IMPORTANT: During cool-down breaks, staff shall be monitored and asked if they are experiencing heat illness symptoms Provide effective means for employees to contact the supervisor and emergency services Ensure close observation of: All staff during a heatwave New employees and employees returning from extended absence

Work Planning and Supervision High Heat Procedure-- when outdoor temperatures higher than 95°F, supervisors shall: Ensure all of the previously noted actions. Regularly monitor employees for alertness and signs/ symptoms of heat illness via: Direct supervision, buddy system, phone/radio communication, and/or other means of observation. Conduct pre-shift meetings to review: How employees are to be monitored during the day Reminder to drink plenty of water throughout the day The employee right to take cool down rests as needed

Work Planning and Supervision As Cal/OSHA requires, keep a local plan for heat illness prevention: Use the template provided in the SU Heat Illness Prevention Guide- Appendix A. The written plan shall minimally cover: Procedures for providing water and access to shade High heat procedures Emergency response procedures Acclimatization methods and procedures Employee and supervisor training shall include these local procedures for heat illness prevention The written plan shall be made available to employees at the worksite Availability can be via smartphone

Supervisor Responsibilities-- Summary Obtain heat illness prevention training Develop and train staff on written local heat illness prevention procedures On a daily basis, assess your staff’s heat stress potential Plan and manage work activities accordingly to reduce the risk of heat stress Provide access to water and shade Ensure routine monitoring of staff during warmer weather Be able to recognize warning signs of heat illness Promptly respond to symptoms of heat illness!

For Additional Information EH&S- Occupational Health and Safety Program Find more information on heat illness prevention at: http://web.stanford.edu/dept/EHS/prod/mainrencon/occhealth/15-101.doc For questions or more information, call 723-0448