Heat Stress Prevention Battle the Heat OBJECTIVES • Identify the causes and risk factors for heat stress. • List the preventive measures for heat stress. • Identify symptoms of heat stress and take appropriate first aid measures. Slide 2 Battle the Heat WHAT IS HEAT STRESS • Heat stress is the name given to a number of illnesses caused when the body heats up and cannot cool down. • These range from the more minor heat fatigue to the life threatening heat stroke. Battle the Heat HEAT GAIN • Heat generated within the body by muscle activity and other body functions. • Direct radiation from the sun’s rays. • Heat transfer from the air. • High humidity which decreases the evaporation of sweat. Battle the Heat HEAT LOSS IS ACHIEVED BY • Evaporation of sweat • Radiation of heat outwards from the body • Transfer of heat from skin to air • Breathing • Urination Battle the Heat HEAT STRESS IS LIKE BOILING EGGS IN WATER Battle the Heat WAYS TO COOL EGGS IN A POT OF BOILING WATER • Remove from heat. • Allow to Rest and water will cool. • Add cool water. • Place in a cool environment. Battle the Heat Battle the Heat BODY TEMPERATURE CONTROL After 1-2 hours: • Core temperature rises • Heated blood is pumped to the skin’s surface • Body heat is transferred to the environment if cooler • Heat needs to be released • Sweating occurs • Sweat evaporates to cool Battle the Heat BODY TEMPERATURE CONTROL The longer the body sweats, the less blood to carry excess heat to skin or oxygen & nutrients to muscles due to heat overload of the body. After 3 hours, if dehydrated symptoms may be: • Headaches • Heat cramps • Nausea • Muscle tiredness • Loss of strength • Loss of accuracy & dexterity • Reduced alertness Description Recognize the Symptoms of Heat Injury Heat Cramps Heat Exhaustion Painful muscle spasms caused by loss of salt from excessive sweating. Advanced and serious stage of heat injury. Body’s temperature is increased and if not treated immediately may result in coma, brain damage or death. • Muscular pain and excessive sweating • Tired, weakness • Increased temperature (very warm to the touch) • Headache Symptoms • Goosebumps, tingling skin • Increased heart rate and breathing, sweating • Nausea Heat Stroke • Mental impairment (agitation, confusion) • Possible loss of consciousness • Headache, nausea, vomiting, flu like symptoms • Rapid breathing, heart rate • Possibly dry skin When In Doubt, Treat as a Heat Injury Battle the Heat CASE STUDY • Concrete Truck Driver, mid 40’s (IP) • Late in his shift, temperature over 100 all day. • Controls are malfunctioning, when team members are requesting stop, more concrete is being poured or visa versa. • When the team assisted the IP to “fix” the problem they recognized the IP looked pale, was fatigued and sluggish. When questioned he complained of feeling tired. • What was really going on? Battle the Heat INDIVIDUAL RISK FACTORS • Age (> 60 years old) • Drug and alcohol use • Low level of physical fitness • Lack of acclimatization • Medical conditions (diabetes, cardiovascular) • Dehydration • Some medications (High blood pressure) Battle the Heat WORKPLACE RISK FACTORS • High frequency, duration or intensity of physical activity • Requirement for use of personal protective equipment and clothing (may increase humidity levels and prevent air flow across the skin) Battle the Heat CASE STUDY • 60 year old male (IP, Injured Person) • IP was trimming grass on right of way at 10:45 am in July. • Passes out. • Works with son who takes him to emergency room. • ER administers IV fluids and discharges man. • Back at work next day. • What were his risk factors? Battle the Heat CASE STUDY • 24 year old male (IP or Injured Person) • Out the night before drank 2 beers, 5 hours of sleep. Arrives at 7:00 am, 4th day on shift. He mixes mud for drilling. • Drinks an energy drink within the first hour at work followed by a 12 ounce bottle of water. He is sweating while lifting heavy bags of mud for mixing. • Passes out at 11:00 am, taken to ER, administered IV fluids. Discharged. Back at work next day. • What could be some risk factors? Battle the Heat WEAPONS-Urine Chart Battle the Heat TO PREVENT DEHYDRATION STEP 1 STEP 2 STEP 3 Ensure you begin hydrating 2 hours before your shift. Drink water until you're are no longer thirsty and then a little more. While working, drink water every 15-20 minutes, targeting one (1) quart per hour. (limit 12 quarts per day) Battle the Heat PHYSICAL INDICATIONS OF DEHYDRATION • Skin Less Elastic; on pinch test, the skin regains its shape slowly. • Urine Reduced in Volume and Frequency; concentrated and darker. • Sweat Higher Sweat Rate; if sweat production suddenly stops, despite continued heat exposure, dehydration has reached a severe level. • Physical Work Capacity Reduced Endurance; accelerated onset of fatigue. • Heart Rate Faster Heart Rate; work seems increasingly more tiring and increases the heart rate rapidly. • Appetite Suppressed Appetite; food intake is reduced during water deprivation, and water intake reduced during starvation. • Mental Indicators Less Alert; increased lethargy; difficulty in concentrating; confusion and irrational behavior. Battle the Heat CASE STUDY • Compressor Station Worker mid 40’s (IP) • Stopped at convenient store in the morning on the way into work to buy an energy drink every morning. • Filled cooler with ice and water at the shop before going to work site. Slowly increased to several energy drinks. • One day passed out by noon. • What happened? Battle the Heat WEAPONS-First Aid Battle the Heat CASE STUDY • 23 year old machine shop worker (IP) • Day 1 Complained of flu like symptoms while working in non AC building moved to trailer with AC. • Day 2 Refused MD visit from manager • Nausea and vomiting, IP said “stomach flu” Still working in AC trailer. • Day 3 Working in AC trailer IP vomiting often early in shift, alert, bright. • Manager took IP to clinic. Battle the Heat CASE STUDY • Clinic- IP alert, looked fine. • MD took a blood sample. • IP rushed to hospital in renal failure and placed on dialysis. • Kidneys and IP saved. • What are the key lessons? Battle the Heat Buddy-Up BUDDY SYSTEM • The buddy system is a culture in which two people (the buddies) operate together as a single unit so that they are able to monitor and help each other. • The main purpose of the system is improved safety. • Each Buddy may prevent the other from becoming a casualty of Heat Stress. Battle the Heat Buddy-Up BUDDY SYSTEM • Buddies need to identify the causes and risk factors for heat stress. • To be able to identify symptoms of heat stress and if appropriate first aid measures. Battle the Heat Buddy-Up BUDDY SYSTEM SCREENING • Have you worked more than 7 days in a row in a hot workplace? • Have you been treated for heat stress in the past? • Have you eaten today? Have you checked your urine for hydration level? • Did you sleep at least 5 hours in the past 24 hours? • Is there anything that has changed in the past 24 hours that would affect your fitness to work today? Battle the Heat Buddy-Up BUDDY SENSE Try to do the most physically demanding jobs during the coolest part of the day. STOP the job if your buddy exhibit any signs or symptoms of heat injury. Battle the Heat WEAPONS-HEAT INDEX • The heat index can be used to help determine the risk of heatrelated illness for outdoor workers, what actions are needed to protect workers, and when those actions are triggered. • NOAA Heat Index chart, which was developed for the public. The NOAA bands have been modified for use at worksites: Battle the Heat WEAPONS-Flag Conditions Red Flag Heat Index Risk Level Protective Measures >115°F • • Very High to Extreme Reschedule non-essential activity Move essential work tasks to the coolest part of the work shift; • Consider earlier start times, split shifts, or evening and night shifts. • Strenuous work tasks and those requiring the use of heavy or non-breathable clothing or impermeable chemical protective clothing should not be conducted when the heat index is at or above 115°F. If essential work must be done, in addition to the steps above: • Alert workers of extreme heat hazards • Establish water drinking schedule (about 4 cups/hour)** • Develop and enforce protective work/rest schedules • Conduct physiological monitoring (e.g., pulse, temp.,etc) • Stop work if essential control methods are inadequate or unavailable. Battle the Heat CASE STUDY • Manager arrived at shop to find worker with coveralls cut off into shorts and short sleeves. • When questioned worker stated “It’s over 100 degrees, it’s hot out there”. • Manager went to location and found ice and water but no shade. • No vehicle idle policy was in effect. • What should be done? Battle the Heat WEAPONS-Heat Stress Management Plan Purpose: Content: • Identify Strategies • Performance Criteria • Awareness and Scope: • Personnel working in high temperatures combined with high humidity. Education • Preparation • Prevention Checklists • Implementation • Training Battle the Heat ROLES & RESPONSIBILITIES • • • • Manager Supervisor Employee Buddy Battle the Heat Battle the Heat TRIED AND TRUE • Buddy System • Accountability • OSHA Program • Take their shoes off! • Increase your count • Forced breaks • Plan your day • Show up with cold fruit Remember once you have heat stress, You are susceptible for life.