Cal/OSHA Consultation Service 2008 Heat Illness Prevention Title 8 Section 3395 Cal/OSHA Consultation Service 2008

Heat Illness Prevention “Safety Basics” POTABLE DRINKING WATER SHADE ALLOWING THE BODY TO COOL PREVENTATIVE RECOVERY PERIODS EMPLOYEE/SUPERVISOR TRAINING WRITTEN PROCEDURES

Enforcement Experience 25 Serious Heat-Related Illnesses May – November 2005 Agriculture 38% Construction 29% Service 12.5% Transportation 12.5% Public Safety 8%

What was discovered… 68% of employees spoke Spanish Ages 17 to 76 yrs 84% of cases involved outdoor work 92% of work was moderate  strenuous 46% of cases happened the 1st day on the job 36% required hospitalization for more than 24hrs 54% of cases resulted in death of the employees

Environmental & Physiological Factors Average Ambient air temperature 96º F (75 - 116º F) Humidity 29% (12% - 55%) Wind speed 7mph Core body temperature 104º F (98 - 108º F)

Worksite Conditions Potable water present - 100% of cases Shade available - 77% of cases 80% of employers had a written IIPP 20% had written Heat Illness Prevention Policy 36% had an Emergency Action Plan

Worksite Conditions Heat Wave - a sudden and temporary rise of temperature above the seasonal average for a particular region, which last for a prolonged period of time Greatly increases the risk of heat illnesses

Heat Wave Impact Temps/Day/Date/Cases Mon Sun Tue Sat Historical Temp from UC IPM CIMIS Note: Direct Relationship Between Temps and Number of Reported Cases 84% of the Cases Occurred During the July 2006 Heat Wave

Worksite Conditions Heat Illness Prevention During Heat Waves Take Extra Measures - More Vigilance Supervisors/employees watch each other very closely & provide more frequent feedback Avoid working alone - “buddy system” Designate person - closely monitor/report employees conditions Account for employee whereabouts throughout the work shift and end of the day

Worksite Conditions Heat Illness Prevention During Heat Waves Take Extra Measures - More Water Employees should drink small quantities of water more frequently before, during and after work Effective replenishment of extra supplies of water Encourage employees to consult with their doctor on salt/mineral replacement

Worksite Conditions Heat Illness Prevention During Heat Waves Take Extra Measures - More Cooling Use other cooling measures in addition to shade Spraying body with water/wiping with wet towels Additional/longer breaks in the shade

Worksite Conditions Heat Illness Prevention During Heat Waves Take Extra Measures - Change Schedule Start work earlier or later in the evening Split-up work shifts - avoid working in hotter parts of the day Cut work shifts short or stop work

Worksite Conditions Heat Illness Prevention During Heat Waves Take Extra Measures - Change Meals Encourage employees to: Eat smaller/more frequent meals ( less body heat during digestion than with big meals) Choose foods with higher water content (for example, fruits, vegetables, salads)

Worksite Conditions Acclimatization Warning Heat Illness Prevention During Heat Waves Acclimatization Warning Even employees previously fully acclimatized are at risk for heat illness Body needs time to adjust to sudden, abnormally high temperatures or other extreme conditions

Heat Illness Prevention 3395(a) Scope and Application Applies to the control of risk of occurrence of heat illness in all outdoor places of employment Does not exclude other Title 8 requirements, such as, IIPP, drinking water, first aid

3395(b) Definitions “ Heat Illness" means a serious medical condition resulting from the body's inability to cope with a particular heat load, and includes heat cramps, heat exhaustion, heat syncope and heat stroke. "Environmental risk factors for heat illness" means working conditions that create the possibility that heat illness could occur, including air temperature, relative humidity, radiant heat from the sun and other sources, conductive heat sources such as the ground, air movement, workload severity and duration, protective clothing and personal protective equipment worn by employees.

3395(b) Definitions “Personal risk factors for heat illness” means factors such as an individual’s age, degree of acclimatization, health, water consumption, alcohol consumption, caffeine consumption, and use of prescription medications that affect the body’s water retention or other physiological responses to heat. “Acclimatization” A temporary adaptation of the body to work in the heat that occurs gradually when a person is exposed to it. Acclimatization peaks in most people within 4 - 14 days of regular work for at least 2 hours per day in the heat.

"Preventative Recovery Period“ 3395(b) Definitions "Shade" means blockage of direct sunlight. Canopies, umbrellas and other temporary structures or devices may be used to provide shade. One indicator that blockage is sufficient is when objects do not cast a shadow in the area of blocked sunlight. Shade is not adequate when heat in the area of shade defeats the purpose of shade, which is to allow the body to cool. For example, a car sitting in the sun does not provide acceptable shade to a person inside it, unless the car is running with air conditioning. "Preventative Recovery Period“ means a period of time to recover from the heat in order to prevent heat illness.

3395(c) Provision of Water Sufficient amounts of cool water available at all times w/at least one quart per employee per hour for the entire shift Easy access to clean and cool water encourages frequent drinking Keep the water replenished

3395(d) Access to shade Preventative Recovery Period (PRP) is necessary if an employee is suffering from heat illness or believes that a rest break is needed to recover from the heat Employees must have access to an area with shade that is either open to the air or provided with ventilation or cooling for a period of no less than 5 minutes

3395(d) Access to shade Access to shade is permitted at all times Non agricultural employers are permitted cooling measures other than shade if alternate means are proven as effective as shade in cooling the body

3395(e) Training Recognition of Environmental & Personal Risk Factors Procedures for Complying with the Regulations Importance of Frequent Consumption of Water Importance of Acclimatization to Working Conditions Recognition of Signs/Symptoms of Heat Illnesses Importance of Reporting Signs/Symptoms to Supervisor Procedures to Follow When Heat Illness is Reported Procedures to Contact Medical Services Means & Methods Available to Transport Ill Workers Procedure to Ensure Clear/Concise Directions are Given to Emergency Medical Responders to Locate the Worksite

Employee Training The environmental and personal risk factors for heat illness Importance of frequent consumptions of small quantities of water Importance of acclimatization Different types of heat illness, common signs and symptoms

Employee Training Importance of immediately reporting signs/symptoms of heat illness to supervisor Procedures for responding to possible heat illness Procedures for contacting and directing emergency medical services to the worksite

Section 3395(e)(1) Employee Training Procedures to follow when contacting emergency medical services and if necessary transporting employees Employers procedures that ensure clear and precise directions to the work site will be provided to emergency medical service providers.

3395(e)(2) Supervisor Training Same information required under employee training PLUS Procedures to follow to implement the applicable provisions of the standard Procedures to follow when an employee exhibits symptoms consistent with heat illness, including emergency response

Impact of Supervisor Training on the Outcome of Heat Illness For Non-Fatal Heat Illnesses, Supervisor Trained on Heat Illness Prevention: Yes (67%) and No (33%)

Employer’s Written Procedures Written policy addresses controlling the risks of heat illness and includes all the elements in Section 3395 Policy and procedures can be integrated within the IIPP Training provided to all employees to recognize heat illness hazards before starting to work outdoors Procedures must be made available to representatives of Cal/OSHA upon request

Internet Resources – Cal/OSHA & NIOSH ADDITIONAL GUIDANCE Internet Resources – Cal/OSHA & NIOSH http://www.dir.ca.gov/DOSH/HeatIllnessInfo.html http://www.cdc.gov/niosh/topics/heatstress/