1. Heat Illness
This section will have some thoughts on how to present as you go through this presentation with your crews.

2. What is Heat illness?
Body is unable to cool itself enough to maintain a healthy temperature.
What causes it?
Environmental factors (heat, humidity,etc.)
Stresses such as hard physical work
Loss of fluids
Some medical conditions
The effects of heat exposure are often regarded as a mere transient discomfort may be low on the list of issues to be addressed in a JSA. However, significant heat exposures can increase fatigue and decrease comfort, productivity, and efficiency leading to health issues, poor judgment and safety related incidents.
Workers become overheated from two primary sources: (1) the environmental conditions in which they work and (2) the internal heat generated by physical labor. 

3. Personal Risk Factors
Although everyone is at risk during extremely high temperatures, people with increased risk include:
Children up to four years of age
People 65 years of age or older
People who are overweight
People who are physically ill, especially with heart disease or high blood pressure, or who take certain medications.  
Consuming these can increase your risk:
Heavy meals
Alcohol
Caffeinated drinks and Energy Drinks “Sports drinks” with high sugar content.  
Blood is used to help regulate body temperature. Blood is what carries the heat from your core to your skin where the blood vessels can open up to act like a regulator (this is why you turn red and get warm to the touch). Medications or health history that incudes cardiac or blood vessel issues may reduce the body’s ability to regulate its temperature.
If you feel that you need a sports drink for electrolyte replacement, chose a low or no sugar version

4. What happens if we overheat?
Heat stroke
is the most serious disorder associated with heat stress. It occurs when the body’s temperature regulation fails and body temperature rises to critical levels. It is a medical emergency that can lead to death.
Heat exhaustion
is a result of the combination of excessive heat and dehydration. Untreated, heat exhaustion can lead to heat stroke.
Heat cramps
are usually the result of hard physical labor in a hot environment, often resulting from an imbalance of electrolytes in the body.
Heat rashes
are a common problem resulting from persistent wetting of clothing by unevaporated sweat.
Symptoms of Heat Exhaustion
• Headache, dizziness, or fainting
• Weakness
• Irritability or confusion
• Thirst, nausea, or vomiting
Symptoms of Heat Stroke
• May be confused, unable to think clearly, pass out,
collapse, or have seizures (fits)
• May stop sweating, dry skin
IF HEAT EXHAUSTION GOES UNTREATED IT CAN LEAD TO HEAT STROKE OR DEATH!

5. How do our bodies cool down?
The best way is by Sweating!
Why does sweating cool us down?
Moisture on the skin evaporates
As it evaporates is takes heat with it
Sweat demo
Sweat demo
>>>Dab skin with water, or lick you finger and touch the back of your hand
>>>Gently blow on the area
>>>The area will feel cool to the touch
PPE and humidity can drastically affect the evaporation of sweat, reducing the body’s ability to control heat.
Increased humidity levels decrease the body’s ability to cool itself through sweating. If the air already contains large amounts of water vapor, your sweat will not evaporate as readily, and your body temperature will not drop as quickly. When considering humidity, you must take into account the immediate environment surrounding your body. 

6. Preventing Heat illness
Good News!
All heat related illnesses are preventable by:
Staying hydrated
Resting in the shade
Following safe work practices
Taking action when heat illness symptoms occur.

7. Water, Water and more water
In order for our bodies to cool it self down by sweating it needs
water!
How much water is recommended?
1 quart per hour
8 hrs. worked = 8 quarts of water
So how much is that?
2 gallons or approx. 15 water bottles (16.9oz)
Avoid energy drinks and large amounts of caffeine
They make it easier for your body to loose water
If you have water bottles or gallons available it would be a great demonstration.
>>>Can be posed as a question
“how many water bottles to you think you need in a 8-hr work shift?” Then start placing water bottles onto table until you reach 15

8. Shade and Rest
Shade is required to be present when the temperature exceeds 85° F
Take breaks and remove PPE to allow body to cool down
Wear lightweight, light colored, loose-fitting clothes when possible
Lightweight clothing is sometimes not an option due to other hazards such as fire or explosion potential. In such cases we need to ensure that the other measures are adequate to address any potential heat stress issues.
Access to shade shall be provided at all times in the following ways:
1. The shade provided from available trees, under or inside structures or shade
produced by the use of large umbrellas provided at the jobsite.
2. Inside air-conditioned vehicle if allowed on site by customer.
3. Inside air-conditioned area designated by customer.
4. Use of mechanical air mover ( fan, blower, etc…) if applicable.

9. Work Practices
If possible, arrange to work during the coolest hours of the day,
Ensure that there is plenty of cool, potable water available – enough for at least a quart an hour per person
Monitor yourself and crew members for signs and symptoms of heat related illness
Establish Work/Rest schedule with crew
If you or your crew members need more frequent or longer recovery periods, make the necessary arrangements.
Rest periods do not necessarily mean that the workers are on break; these can be productive times. During the rest periods, workers may continue to perform mild or light work, such as completing paperwork, sorting small parts, attending a meeting, or receiving training (e.g., instructions for upcoming work, or a tailgate safety talk).
Shorten work periods and increase rest periods:
As temperature rises
As humidity increases
When sun gets stronger
When there is no air movement
For heavier work
Assign new and un-acclimatized workers lighter work and longer rest periods. Monitor these workers more closely.

10. High-heat procedures When the temperature ≥ 95°F.
High-heat procedures shall include, but are not limited to:
Ensuring that effective communication by voice, observation, or electronic means is maintained
Observation of employees for alertness and signs/symptoms of heat illness
Reminding employees to drink water throughout the shift
This includes ensuring employees leave the branch with extra water
Closely supervising employees for the first 14 days of employment
High-heat procedures shall include, but are not limited to:
1. Effective communication. Effective communication includes:
a. Voice
b. Observation/Hand signals
c. Cell Phones
d. GPS
e. Radios
f. Others forms that allow for ensuring employee wellbeing
2. Observation of employees for alertness and signs/symptoms of heat illness (see
attachment one of this policy for the signs and symptoms.)
3. Reminding employees to drink water throughout the shift
a. This includes ensuring employees leave the branch with extra water
b. How much water depends on:
i. Number of employees
ii. Type of work
iii. Experience of employees
iv. Working conditions
v. Access to additional water
vi. Other factors including personal (age, medications, etc.), environmental and
site specific.
4. Closely supervising employees for the first 14 days of employment 
Note: employees need time for their bodies to adjust to outdoor labor in high heat.
These employees may need extra water, additional rest periods, and increased
communication to assess their physical wellbeing

11. Give specific and clear directions to your
Emergencies
How to recognize an emergency:
Employee passes out/loss of conciseness
Employee has an altered mental status
Can not remember simple items such as their name, where they are, day of the week, etc.
Talking in slurred speech
Unable to drink fluids on their own
Hot to the touch and no longer sweating
Employee is unable to walk on their own
Call 911
Give specific and clear directions to your
work site.

12. Treatment Move the worker to a cool, shaded area.
Loosen or remove heavy clothing.
Provide cool drinking water in small amounts.
Fan and mist the person with water.
Do not force water into the employee, hand them the glass/bottle to drink from. If the employee is unable to drink without assistance, you should contact emergency medical services.
If a person is having a heat related issue and you want to give a sports drink, cut it 50% with water.

13. Additional Resources Heat illness fact sheets
Heat Illness Poster
Heat Stress Training video in English and Spanish
If audio/video is available the video link above provides a good summary of the training information.