Heat Illness Prevention - Take a Proactive Approach

With summer in full swing in the northern hemisphere, many companies are starting to focus on managing the risks associated with working in high temperatures. However, heat risks can also be present in moderate temperatures, and while performing indoor work (e.g., bakeries, kitchens, welding & fabrication shops), and heat risks can arise due to a lack of acclimatization to new temperatures and/or work environments. In fact, OSHA considers that the “lack of acclimatization represents a major risk factor for fatal outcomes,” and notes that 50%-70% of outdoor fatalities occur during the first few days of working in warm or hot environments.

So how do we prepare our employees to work in hot environments and to prevent the lack of acclimatization that can lead to heat illness and death? By taking a proactive, rather than passive, approach to heat illness prevention, we can better ensure the health and safety of our employees. OSHA launched its heat campaign in 2011 with the catchphrase, “Water. Rest. Shade.” By taking a proactive rather than passive approach to implementing these measures, companies and work teams can address extreme heat at their job sites before workers are adversely impacted. A job safety analysis (JSA) or activity hazard analysis is a great place to review and plan how to handle extreme heat at the job site.

Water. Employers need to provide water and educate workers about the importance of drinking water frequently – before they are thirsty. OSHA suggests that workers should consume at least 8 ounces of water every 20 minutes while working in the heat. This applies to both indoor jobs and outdoor jobs. While employers may provide water and educate workers on the importance of hydrating, work teams will likely have greater success in meeting hydration goals if a water-break plan is discussed with the work team, and workers or supervisors are able to hold each other accountable to follow it.

Questions to consider as you prepare your heat plan or job safety analysis:

  • What type of heat are we anticipating for the day, and what is our water consumption goal for each worker?
  • What does this mean with regards to how often workers should be pausing to take a drink of water?
  • How will we ensure each worker is meeting the water consumption goal?
  • What is our plan for monitoring weather and work conditions in order to determine if water consumption goals need to be increased (or decreased) throughout the day?
  • Is our team familiar with signs and symptoms of dehydration in others and in themselves?
  • How will we monitor workers to catch any signs or symptoms of dehydration, regardless of how much water they are consuming?
  • Will water, ice, and/or electrolyte-enhanced beverages be provided at the job site for workers to take as needed?
  • If workers normally consume caffeinated or sugary beverages, how much additional water will they need to consume to balance the effects of those beverages?

Rest. Employers should require workers to take rest breaks when temperatures increase the risk of heat stress. Length of break and frequency will vary, depending on how quickly the worker is able to cool down. Hot work environments, with heavy PPE clothing/gear, and strenuous labor may mean more frequent and longer breaks. While employers may offer a set of rest-break requirements, work teams will likely experience greater success in achieving these goals if the plan is discussed with the work team, and a system of accountability is established to ensure all workers are taking the needed amount of rest. Documenting the rest break accountability plans in the daily JSA provides easy reference for all site workers.

Questions to consider as you prepare your heat plan or job safety analysis:

  • What are the expected temperatures and humidity, and how strenuous are the work tasks that will be implemented today? How will equipment, PPE, clothing, gear, or other factors contribute to the heat? And how will personal risk factors, such as general health, body mass, amount of sleep, and acclimatization affect the workers’ health throughout the day?
  • Can any of the above risk factors be eliminated or further mitigated (e.g., lighter weight PPE, different fabrics, adjust site layout)?
  • How frequently should workers take a break, and for how long?
  • How will we ensure each worker is taking the required breaks?
  • What if a worker “feels fine” and does not want to take a break?
  • What if a worker needs additional or longer breaks?
  • Is everyone on our team familiar with the signs and symptoms of heat illness in others and in themselves?
  • What is our plan to monitor workers for signs and symptoms of heat illness?
  • How will we adjust our work goals to properly align with the frequency and duration of rest breaks needed?
  • Can our work schedule be adjusted so that we are working during cooler hours of the day?
  • Shade. Employers should provide rest areas that are (ideally) cooler than the warm work environment and that are shaded for outdoor workers; the area should be suitable so that workers can take breaks and recover from the heat. If the break area is significantly cooler than the work environment, workers may cool down more quickly. However, if the break area is only moderately cooler, breaks may need to be longer to allow workers to fully cool. This applies to both indoor jobs and outdoor jobs. NIOSH provides guidance on their website regarding managing heat stress (https://www.cdc.gov/niosh/topics/heatstress/recommendations.html) and also provides more detailed information in a technical document (https://www.cdc.gov/niosh/docs/2016-106/pdfs/2016-106.pdf). As with water and rest, a system of accountability to ensure all workers are spending an adequate amount of time in shaded areas, out of the heat relative to the day’s temperature and humidity, may help to ensure a greater level of success in achieving this goal, and the daily job safety analysis is a great place to record this.

    Questions to consider as you prepare your heat plan or job safety analysis:

    • What type of “shaded” environment are we providing for rest breaks, and how much cooler in temperature is it than the work area?
    • Is it possible (or necessary) to provide a cooler rest area?
    • Considering both the type of “shaded” break area, and the temperature, humidity, work, and risk factors outlined above (in the “rest” section), is our rest break goal realistic and appropriate, or do we need to adjust it to take into consideration the temperature difference between work area and rest area?

    For quick information on keeping workers safe in the heat, review OSHA’s short heat illness prevention video below and share with your team:

    Employee Buy-In. OSHA’s case studies webpage recaps a work-related death due to extreme heat. Even though the job site provided water, ice, and electrolyte drinks, the worker did not realize his need to take a break until it was too late (https://www.osha.gov/SLTC/heatstress/casestudies.html). In 2018, OSHA recorded 49 work-related deaths due to extreme heat. While it is important for the employer to have a heat illness prevention plan, and to offer water, rest breaks, and shade, the plan needs to be understood and followed at all employee levels – from management to technicians at the job site. Employer, manager/supervisor, and worker need to be on the same page when it comes to preventing heat illness and recognizing its signs and symptoms, and they all need to take it seriously.

    Even in the best of circumstances, a worker can still experience signs and symptoms of dehydration or heat illness. Early signs and symptoms may include thirst, heavy sweating, elevated body temperature, rash, dark urine, and psychological signs, such as irritability and fatigue. Workers may claim they feel fine and may feel a need to continue to “push through” and “just get the job done,” but at this point, they should stop, rest, and rehydrate. Left unchecked, these signs and symptoms could develop further to muscle cramps and spasms, rapid heart rate, continuing elevated body temperature, kidney damage, or dangerous psychological signs such as slurred speech, confusion, seizures, or unconsciousness. Workers exhibiting these conditions need to be cooled immediately and members of the work team need to seek medical attention for the affected worker.

    Extreme heat can be an underrecognized hazard in both indoor and outdoor work, regardless of the season. Take some time to review your plan, and to make sure your job site is equipped to offer water, rest, and shade – and make sure your work team is fully on board with taking a proactive rather than passive approach to heat illness prevention! Stay safe out (or in) there!

    OSHA offers resources on recognizing heat illness signs and symptoms, first aid, how to prevent heat illness, heat standards, and other resources.

    • OSHA heat campaign: https://www.osha.gov/heat/ (includes links to educational and training materials, symptoms and prevention, and other resources and information)

  • Heat Illness Prevention Plan
  • Additional heat illness prevention resources: here and here
  • Visual heat and humidity index (also available as an app!)
  • OSHA printable heat stress card
  • If you or your employer would like help setting up an appropriate heat illness prevention program, and you are a small or medium sized business, contact OSHA’s free, confidential On-Site Consultation Program. On-Site Consultation Services are separate from OSHA enforcement and do not result in penalties or citations.

    JSABuilder.com is a fantastic on-line job safety analysis app to assist in preparing your JSA worksheet or activity hazard analysis form. Set up a free trial account today and follow us on Twitter @JSABuilder, where we Tweet about Health and Safety, provide Safety tips, and updates on current Health and Safety topics. As always, JSABuilder’s safety consultants are also happy to work with your small, medium, or large sized business or facility to help identify and mitigate heat and other hazards associated with the job.

    If your supervisor or health and safety manager does not take your concern seriously, you can file a complaint with OSHA here. In 2018, nearly a quarter of OSHA’s inspections were the result of complaints that had been filed by employees or others OSHA will review your complaint and determine what type of action to take. Remember, your complaint is just that – a complaint. By reporting something that is not right, you may be providing your employer the opportunity to hear that message from an authority and make changes to fix it.