By: Thomas H. Welby Published: August 2011

Safety Policy: OSHA Campaigns Against Heat-Related Illness

In many parts of the United States, July 2011 was the hottest July on record. It’s quite appropriate, therefore, that heat-related illnesses are one of the hazards currently receiving heightened attention from (federal) OSHA and state OSHA agencies around the country.

Each year there are several dozen workplace fatalities due to heat stroke and other heat-related illnesses. Such deaths are most common in agriculture, mining, foundry work, and construction. Probably the construction trades most at risk are roofers - working with no shade with buckets of hot tar - and workers in highway construction.

Too much heat exposure makes employees listless, unproductive, and more prone to accidents. Heat stress can result in dehydration, heat rash ("prickly heat"), and muscle cramps. Most seriously, heat stress can lead to heat exhaustion and heat stroke.

The signs of heat exhaustion are headache, nausea, dizziness, weakness, irritability, confusion, thirst, heavy sweating, and a body temperature over 100.4° F. First aid for heat exhaustion includes removing the worker from the hot area, giving water or other (non-alcoholic) liquids, and the removal of unnecessary clothing (shoes and socks included).

Workers with heat exhaustion should be treated promptly, with cold compresses to the head, neck and face (or washing those areas with cold water). Frequent sips of cool water should be taken. Since heat exhaustion usually is associated with the loss of electrolytes, sports drinks containing potassium, calcium, and magnesium salts should be given if available.

Workers suspected of having heat exhaustion should be taken to an emergency room or similar facility for evaluation, and should not be left alone while awaiting transport or medical attention.

Heat stroke is a life-threatening condition, of which the symptoms are mental confusion, delirium, loss of consciousness, convulsions or coma; a body temperature over 104º F.; and hot dry skin, which may be red, mottled, or bluish. If heat stroke is apparent, summon emergency medical assistance at once. While awaiting medical help, remove the victim to a cool area, soak the victim and his clothing with cool water, and fan the victim vigorously to increase cooling. These measures should not be neglected; they may make the difference in preventing permanent injury to the brain and other vital organs.

Heat cramps and heat syncope (a/k/a fainting) are other heat-related conditions. Heat cramps generally result from the overuse of tired muscles in a hot environment without replacing electrolytes. Large quantities of water generally do not help, but often make the situation worse. Rest, sports drinks or - in unusually severe cases - the intravenous administration of saline solution by a medical professional are the usual treatments.

Fainting occurs most often when the worker is not acclimated to the hot environment and stands still in the heat. Moving around will usually help the individual avoid passing out, and most who do faint recover after a brief period of lying down.

Engineering measures should be considered (especially where work is to be done in elevated temperatures indoors). These include, among other things, general ventilation and local exhaust ventilation at points of high heat production; shielding from radiant heat sources; the use of air conditioning and/or dehumidifiers, if practicable; cooling fans; and the elimination of steam leaks.

The ready availability of drinking water is indispensable to preventing heat stress illnesses, and workers should be instructed to drink some water every 15 minutes in hot temperatures, even if they do not feel thirsty.

Regular breaks are also vital, and if your site is not convenient to a shaded area out of the sun, consider a small investment in an open canopy (these are much used in agricultural settings) to provide a shaded rest area. A few chairs and a water cooler can be placed beneath the canopy, and this will be much appreciated by your employees.

While hard hats are of course usual in construction work, employees not required to wear hard hats should be instructed to wear a hat when temperatures are high, and all workers should be told to wear lightweight, light-colored clothing. Workers required to work in protective gear should, of course, be given extra breaks, and efforts should be made to perform such work outside the hottest hours of the day.

Individuals vary widely in their ability to handle hot work environments. Age, obesity, fitness, medical conditions such as high blood pressure, drug and alcohol use etc. all figuring in a person’s sensitivity to heat. These are matters for discussion with supervisors and employees in allocating work assignments.

As always, it’s important to know where your employees are working, and the location of the nearest emergency room or other urgent care facility.

As with most safety practices, training supervisory and rank-and-file employees to recognize and to call attention to symptoms of heat stroke in themselves and others is critical. When temperatures are high, productivity is going to slip somewhat. But encouraging your employees to get out of the sun, drink water, and take rest periods will put less of a dent in production than having employees removed to hospital (or worse) due to heat exhaustion or heat stroke.

Training on this topic should include warnings about the use of alcohol and drugs in hot work environments. Workers who take prescription medications should be strongly encouraged to consult their medical professionals concerning the possibility that their medication, or the underlying condition, may make them more susceptible to heat-related illness.

As with so many health and safety issues, your leadership is important. In difficult economic times, especially, most employees want to "progress the work" (and to keep their jobs). Those, obviously, are good things - but not at the cost of heat stroke! Make sure your employees know, therefore, that they should look out for one another, do what they need to do to avoid (especially) heat stroke and heat exhaustion, and alert supervisors if they, or co-workers, exhibit symptoms of heat-related illness.

Encourage employees, also, to suggest practical means (such as adjusting work schedules or means and methods) to minimize heat exposure, especially on very hot days.

While at present OSHA does not have regulations directed specifically to heat stress hazards, this is an obvious area for application of the "General Duty Clause," which requires employment and a place of employment free from recognized hazards, causing or likely to cause death or serious physical harm. Certainly, heat-related illness is a recognized hazard in construction, and one amenable to mitigation.

As temperatures break records around the country, heat stress is also a condition that OSHA has squarely in its sights, so this "word to the wise should be sufficient."

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