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Monitoring Monday – Heat Illness Prevention
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Join us on Mondays as the Clean Water Team shares information and resources on water quality monitoring. This Monday we will look at heat illness prevention.
 Staff and volunteers who are exposed to extreme heat may be at risk of heat related occupational illnesses and injuries. Heat stress can result in heat stroke, heat exhaustion, heat cramps, or heat rashes. Heat can also increase the risk of injuries in workers as it may result in sweaty palms, fogged-up glasses, and dizziness.
Individuals at greater risk of heat stress include those who are 65 years of age or older, are overweight, have heart disease or high blood pressure, or take medications that may be affected by extreme heat.
Prevention of heat stress in workers is important. Organizations should provide training so that people understand what heat stress is, how it affects their health and safety, and how it can be prevented.
Millions of U.S. workers are exposed to heat in their workplaces. Although illness from exposure to heat is preventable, every year, thousands become sick from occupational heat exposure, and some cases are fatal. Most outdoor fatalities, 50% to 70%, occur in the first few days of working in warm or hot environments because the body needs to build a tolerance to the heat gradually over time. The process of building tolerance is called heat acclimatization. Lack of acclimatization represents a major risk factor for fatal outcomes.
Risk factors for heat illness include heavy physical activity, warm or hot environmental conditions, lack of acclimatization, and wearing clothing that holds in body heat.
In a warm environment, especially when physically active, the human body relies on its ability to get rid of excess heat (i.e., heat dissipation) to maintain a healthy internal body temperature. Heat dissipation happens naturally through sweating and increased blood flow to the skin. People cool down more rapidly if the external (environmental) heat and physical activity (metabolic heat) are reduced.
If heat dissipation does not happen quickly enough, the internal body temperature keeps rising and the worker may experience symptoms that include thirst, irritability, a rash, cramping, heat exhaustion, or heat stroke.
Heat stroke is the most severe heat-related illness. Workers suffering from heat stroke experience mental dysfunction such as unconsciousness, confusion, disorientation, or slurred speech. Cool these workers immediately and call 911!
It is important for project leaders to watch for heat advisories so that field work can be safely planned. Field staff and volunteers should know how to safely work when it is hot outside. Everyone should also know the symptoms of excessive heat exposure and the appropriate responses.
Steps to Prevent Heat Illness
- Plan – Develop and implement an effective written heat illness prevention plan that includes emergency response procedures.
- Training – Train all volunteers, employees, and supervisors on heat illness prevention.
- Water – Provide drinking water that is fresh, pure, and suitably cool so that each worker can drink at least 1 quart per hour and encourage field persons to do so.
- Rest – Encourage field persons to take a cool-down rest in the shade for at least five minutes when they feel the need to do so to protect themselves from overheating. Workers should not wait until they feel sick to cool down.
- Shade – Provide access to proper shade when temperatures exceed 80 degrees.
 Monitor Heat Advisories
Excessive Heat Warning—Take Action! An Excessive Heat Warning is issued within 12 hours of the onset of extremely dangerous heat conditions. The general rule of thumb for this Warning is when the maximum heat index temperature is expected to be 105° or higher for at least 2 days and night time air temperatures will not drop below 75°; however, these criteria vary across the country, especially for areas not used to extreme heat conditions. If you don't take precautions immediately when conditions are extreme, you may become seriously ill or even die.
Excessive Heat Watches—Be Prepared! Heat watches are issued when conditions are favorable for an excessive heat event in the next 24 to 72 hours. A Watch is used when the risk of a heat wave has increased but its occurrence and timing is still uncertain.
Heat Advisory—Take Action! A Heat Advisory is issued within 12 hours of the onset of extremely dangerous heat conditions. The general rule of thumb for this Advisory is when the maximum heat index temperature is expected to be 100° or higher for at least 2 days, and night time air temperatures will not drop below 75°; however, these criteria vary across the country, especially for areas that are not used to dangerous heat conditions. Take precautions to avoid heat illness. If you don't take precautions, you may become seriously ill or even die.
Excessive Heat Outlooks—Be Aware! The outlooks are issued when the potential exists for an excessive heat event in the next 3-7 days. An Outlook provides information to those who need considerable lead-time to prepare for the event.
If You Have to Work While It’s Hot Outside
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Prevent heat illness with acclimatization.
- Drink plenty of water, and don’t wait until you are thirsty to drink.
- Avoid alcohol or liquids containing large amounts of sugar.
- Wear and reapply sunscreen as indicated on the package.
- Ask if tasks can be scheduled for earlier or later in the day to avoid midday heat.
- Wear a brimmed hat and loose, lightweight, light-colored clothing.
- Spend time in air-conditioned buildings during breaks and after work.
- Encourage co-workers to take breaks to cool off and drink water.
- Follow additional tips on how to prevent heat-related illness.
 Learn How to Spot Heat-Related Illness
Heat Cramps
Heat cramps usually affect workers who sweat a lot during strenuous activity. This sweating depletes the body’s salt and moisture levels. Low salt levels in muscles cause painful cramps. Heat cramps may also be a symptom of heat exhaustion. Heat cramps may be the first sign of heat-related illness, and may lead to heat exhaustion or stroke.
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Symptoms: Painful muscle cramps and spasms usually in legs and abdomen and Heavy sweating.
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First Aid: Apply firm pressure on cramping muscles or gently massage to relieve spasm. Give sips of water unless the person complains of nausea, then stop giving water. Seek immediate medical attention if cramps last longer than 1 hour.
Heat Syncope
Heat syncope is a fainting (syncope) episode or dizziness that usually occurs when standing for too long or suddenly standing up after sitting or lying. Factors that may contribute to heat syncope include dehydration and lack of acclimatization.
- Symptoms: Fainting (short duration), dizziness, light-headedness from standing too long or suddenly rising from a sitting or lying position,
- First Aid: Sit or lie down in a cool place; slowly drink water, clear juice, or a sports drink.
Rhabdomyolysis
Rhabdomyolysis (rhabdo) is a medical condition associated with heat stress and prolonged physical exertion. Rhabdo causes the rapid breakdown, rupture, and death of muscle. When muscle tissue dies, electrolytes and large proteins are released into the bloodstream. This can cause irregular heart rhythms, seizures, and damage to the kidneys.
- Symptoms: Muscle cramps/pain, ,abnormally dark (tea or cola-colored) urine, weakness, exercise intolerance,
- First Aid: Stop activity, drink more liquids (water preferred), seek immediate care at the nearest medical facility, Ask to be checked for rhabdomyolysis (i.e., blood sample analyzed for creatine kinase).
Heat Exhaustion
Heat exhaustion is the body’s response to an excessive loss of water and salt, usually through excessive sweating.
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Symptoms: Heavy sweating, weakness or tiredness, cool, pale, clammy skin; fast, weak pulse, thirst, irritability, muscle cramps, dizziness, heavy sweating nausea or vomiting, headache, fainting, elevated body temperature or fast heart rate,
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First Aid: Move person to a cooler environment, preferably a well air conditioned room. Loosen clothing. Apply cool, wet cloths or have person sit in a cool bath. Offer sips of water. If person vomits more than once, Seek immediate medical attention if the person vomits, symptoms worsen or last longer than 1 hour.
Heat Stroke
Heat stroke is the most serious heat-related illness. It occurs when the body can no longer control its temperature: the body’s temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. When heat stroke occurs, the body temperature can rise to 106°F or higher within 10 to 15 minutes. Heat stroke can cause permanent disability or death if the person does not receive emergency treatment.
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Symptoms: Throbbing headache, confusion, slurred speech, nausea, dizziness, unconsciousness, seizures, body temperature above 103°F, hot, red, dry or damp skin, rapid and strong pulse, fainting, loss of consciousness.
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First Aid:Call 911 or get the victim to a hospital immediately. Heat stroke is a severe medical emergency. Delay can be fatal. Move the victim to a cooler, preferably air-conditioned, environment. Reduce body temperature with cool cloths or bath. Use fan if heat index temperatures are below the high 90s. A fan can make you hotter at higher temperatures. Do NOT give fluids.
- Using a fan to blow air in someone’s direction may actually make them hotter if heat index temperatures are above the 90s. For more information on all of these heat related illnesses, see the Centers for Disease Control and Prevention(CDC) site.
REFERENCES
Cal/OSHA Reminder: Protect Outdoor Workers from Heat Illness During Period of Excessive Heat in California https://www.dir.ca.gov/DIRNews/2022/2022-46.html
Extreme Heat https://www.cdph.ca.gov/Programs/EPO/Pages/Extreme%20Heat%20Pages/BI_Natural-Disasters_Extreme-Heat.aspx
Heat and Outdoor Workers https://www.cdc.gov/disasters/extremeheat/workers.html
Heat-Related Illnesses and First Aid https://www.osha.gov/heat-exposure/illness-first-aid
Heat Safety Brochure https://www.weather.gov/media/safety/Heat-brochure17.pdf
Heat Stress https://www.cdc.gov/niosh/topics/heatstress/default.html
National Integrated Heat Health Information System https://www.heat.gov/
National Weather Service https://www.weather.gov/
The Impacts of Climate Change on Human Health In The United States: A Scientific Assessment https://health2016.globalchange.gov/low/ClimateHealth2016_09_Populations_small.pdf
Working in Outdoor and Indoor Heat Environments https://www.osha.gov/heat-exposure
Disclaimer:
The information provided in this message are for general informational purposes only. Any information about providers and services contained on this website does not constitute endorsement or recommendation.
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