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Avoiding Heat Related Injuries​

This module will introduce you to the hazards of high heat environments and working outdoors, how to mitigate these hazards and information that every supervisor needs to know if they are going to supervise employees working in high heat conditions. After reviewing all of the information click on the button at the bottom of the page to continue to the test. You must score at least an 80% or greater to receive a certificate for this training. 
















                                                                                                                                     
E Light Electric Services, Inc.
2019

Session Objectives
  
•Understand how hot conditions affect your body

•Recognize symptoms of heat illness


•Take precautions to reduce the risk of heat illness


•Understand OSHA Requirements


•Treat Heat Related Injuries
  

How the body keeps us cool

The human body needs to maintain an internal temperature of approximately 98.6°F in order to function correctly. If the internal temperature is below or above that level it could lead to serious health threats. Fortunately, the human body has built in mechanisms to help maintain that temperature. 

  
Let’s begin by talking about the body’s cooling system. Before we can talk about heat-related illness and what to do about it, you need to understand how your body attempts to cope with heat.

•Your body has a natural cooling system that is used to protect internal organs from increases in temperature. When blood temperature exceeds 98.6 degrees         Fahrenheit (°F), your heart rate increases and blood circulates closer to the surface of the skin. This allows heat to transfer out of the blood and into the cooler     environment outside the body. But this heat transfer is only effective if the temperature outside the body is less than inside.
•If your body can’t lose enough heat by transferring heat out of the bloodstream, your brain will signal the sweat glands to start sending fluids to the surface of        the skin.
•Once the sweat reaches the surface of the skin, the sweat will be evaporated off the skin by the hot, dry environment outside the body. The body’s heat will              leave with the evaporated sweat, but when humidity is high, the body’s cooling system isn’t very effective. High heat prevents cooling through heat transfer            out of the bloodstream, and high humidity prevents sweat from evaporating. The result can be heat-related illness. 
  
The Heat Equation
  
The Heat Equation is a simple way to determine the circumstances under which the body’s cooling system could fail and you could face a higher risk of heat illness.

•Basically, a work environment with high temperature and high humidity where physical work is being performed is a prime breeding ground for heat-related            illness.
But as you’ll see in the next two slides, there are other factors that you must also take into account besides the basic Heat Equation.

     High Heat​​
+  High Humidity
+  Physical Work
=  Heat Illness

Additional Heat Stress Factors

In addition to temperature and humidity, you may also have to take into account factors such as radiant heat and air velocity.

•Radiant heat has a significant impact on the amount of stress your body could face in a given work environment. For example, working around ovens, molten            metals, furnaces, and other sources of high heat adds to the effect of the temperature in the outside environment, compounding the heat stress you face.

•Another important factor related to heat stress is air velocity. Stale, stagnant air or a hot wind increase heat stress, whereas a cool breeze reduces heat stress.

Think about your own work environment. Are you ever exposed to heat-related stress? What about environments outside of work such as at home or with recreational activities during the hot months of the year?


  
Personal Sensitivity To Heat

  
Along with environmental factors that tend to increase the potential for heat-related stress and illness, you also have to take into account your own sensitivity to heat. There are a number of factors that affect your sensitivity to heat.

•Acclimatization, or getting used to heat, is a very important factor. The body can take 5 to 7 days to condition itself to working in the heat. If you’re not used to       it, you’re much more susceptible to heat-related illness.

•People who do not stay regularly hydrated throughout the day, even in the evening, are more likely to be affected by heat stress.

•Age is also a factor. Older workers are often at greater risk than younger workers.


•People who are overweight, are pregnant, have had inadequate rest, or are just physically unfit are more likely to be affected by heat stress, as is a person who        is sick.


•People have different rates of metabolism. Those who sweat at a higher rate are less susceptible to heat stress.


•Finally, consuming too much alcohol after work contributes to dehydration and can affect the way a person’s body responds to working in hot conditions the            next day.
  

Signs & Symptoms of Heat Related Injuries

  
  Heat Rash  

Now let’s turn our attention to the different kinds of heat-related illness. Heat rash is the least severe of the heat-related illnesses. But although it’s only a minor health problem, heat rash can be very uncomfortable.

•Heat rash typically occurs in hot and humid environments where the sweat can’t evaporate off the body.

•Heat rash symptoms include a red, bumpy rash that often itches. Scratching the rash may cause further complications if scratched skin becomes infected due          to exposure to dust and dirt.


•Itching related to heat rash can sometimes make sleeping difficult, too.


•Heat rash can be prevented by taking regular breaks in a cool place when it’s very hot and humid so that your body stops sweating for a while. Keeping your             skin as dry and clean as possible also helps prevent or treat heat rash.


If you’ve ever had heat rash, you know how uncomfortable it can be. That’s why it’s wise to take preventive measures.
  
Fainting (Heat Syncope)

  
Another relatively minor type of heat-related illness is called heat syncope, better known as fainting.

•Fainting generally occurs when a person has not yet become used to or acclimated to working in a hot environment.

•It also usually happens when someone is doing a job that doesn’t require much movement and is just standing still in the heat most the time.


•What happens then is that the blood pools in the legs, which reduces the amount of blood that goes to the brain. This results in fainting.


•You can usually recover quickly from a fainting spell by lying down in a cool, shady area for a while with legs slightly raised.


•Fainting in hot weather can be prevented by moving around a little, rather than standing still for long periods. Moving around helps maintain adequate blood         volume in your brain.
  


Heat Cramps

  
A more severe form of heat-related illness is known as heat cramps.

•Heat cramps are painful muscle cramps. Tired muscles are the most susceptible. So if you’re not in good physical shape or are not used to the work, you’re                 more susceptible to heat cramps.

•Heat cramps are usually caused when the body’s salt, which is lost by sweating, is not replaced. Drinking water will replace the liquid that your body loses but          may not adequately replace the salt that was lost.


•Drinking electrolyte liquids such as sports drinks can help prevent or treat heat cramps.


•Severe cases of heat cramps may require a visit to the doctor, who will use an intravenous saline solution to replace salt.



Heat Exhaustion

  
Now we’ll discuss the really serious heat-related illnesses.

•Heat exhaustion, the second most-serious type of heat illness, is the result of loss of fluid or salt, or both, through sweating. The victim does not take in enough      liquids and electrolyte solutions when working to maintain adequate levels of fluid and salt.

•Symptoms of heat exhaustion include weakness, dizziness, and nausea.


•The victim’s skin feels clammy and the complexion is pale or flushed. Body temperature may also be above normal.


•Treatment for heat exhaustion includes resting in a cool place and drinking electrolyte fluids. You should also loosen or remove heavy clothing and try to cool         victims by fanning them, spraying them with a cool mist of water, or applying a cool, wet cloth.


•Severe cases of heat exhaustion may result in vomiting or loss of consciousness. Call for emergency assistance immediately if first-aid treatment does not help      and a victim starts vomiting or loses consciousness. Remember that severe cases of heat exhaustion can advance quickly to heatstroke. So don’t hesitate to              call for medical assistance.



Heat Stroke


•Heatstroke is the most serious type of heat illness. It occurs when the body’s natural cooling mechanism stops functioning and the victim stops sweating. Body temperature may reach 106°F or higher.

•Symptoms of heatstroke include very hot and dry skin.


•The victim will also become confused or delirious and may begin to suffer convulsions or seizures, and collapse or lose consciousness.


•Without immediate medical treatment, a victim could die. Call for an ambulance as soon as you notice symptoms of heatstroke.


•While waiting for help to arrive, move the victim to a cool spot. If the victim is conscious, provide plenty of fluids. Never give liquids to an unconscious person.          Remove any heavy outer clothing. Keep the victim cool by soaking clothing with cool water or spraying with mists of water. If ice packs are available, place                them under the victim’s armpits and in the groin area. Fanning will also help.


Remember that heatstroke is a life threatening illness and that untreated heat exhaustion can quickly lead to heatstroke.
  
Engineering Controls

  
As you can see, working in hot conditions can be hazardous for many different reasons. One way to deal with hot conditions in the workplace and reduce the risk of heat-related illness and accidents is to use engineering controls.

•One of the prime controls used to reduce heat in the workplace is general ventilation. For example, ventilation might include removing heat from the building          with  exhaust fans or blowing air through the building to create a crosswind that reduces the heat stress by improving air velocity.

•Spot cooling can also be used, such as providing an exhaust system for a specific heat source like an oven or melting pot. Spot cooling removes the heat before        it  reaches nearby workers. Another example of spot cooling is focused air-conditioning, which blows cool air over a workstation or area where a worker will be       stationed  throughout the day. Even outdoor workers can benefit from spot cooling by using a fan and water mist system like the ones used by professional             football teams during summer practice sessions.


–Cool Water Supplies
•Use roving water resupplies to employees in the sun. Sometimes employees are hesitant to come to water. Take it to them.

  
–Hardhat brim extenders.
•If crews work in the sun all day, ask for brim extenders

  
•WATER, WATER, WATER
–Keep the water cool
–Have enough on site to provide two full bottles of water (16 ozs) to each employee every hour
–Order Electrolyte Packets from Wise and have a stock of them
   
•Shielding workers from radiant heat sources is another way to control heat stress. For example, workers and workstations might be located inside an air-                         conditioned control room. Heat-resistant shields might be installed around ovens or melting pots. Workers can stand behind the shields while observing the                 equipment. Outdoor workers might be provided with tent-like devices that shade them from the radiant heat of the sun.


•Whenever possible, machinery can also be used so that workers don’t have to use manual methods that put more stress on the body. For example, in hot work        environments employees might control machine operations from inside a cool control booth, thus greatly reducing the risk of heat-related illness.

  
–Allow for frequent breaks for short periods
–Inspect employees daily to ensure they are dressed properly 
–Remind them to drink
–Remind them to wear sunblock
    
•OBSERVE, OBSERVE, OBSERVE,
•Watch yourself for the signs
•Take the time to look at everyone  you come in contact with to see if they are showing the signs.


If you are not sure if they are or not, err on the side of caution
  
  
  
  

  
Basic OSHA Requirements

OSHA has defined three seperate breakpoints:

•70°F - At this temperature the jobsite will need to be sure it has a written plan for how to handle high heat conditions. Each employee working on the site must     be trained on this plan. The plan must also be posted on the site where employees have access to it. 

•80°F - When temperatures are at or exceed this temperature the employer must provide shaded work areas which are strictly defined. 

•90°F - When temperatures are at or exceed this temperature the employer must provide a minimum of 32oz of water to each employee each hour. 
E Light Electric Specific Policies

•Anytime the temperature is expected to exceed 90°F each employee shall be issued an electrolyte packet at the start of the day.

•Each employee will drink a full bottle of water with the electrolyte package inserted, under supervision observation, before the end of the morning stretch and      flex.
  

Provisions of Water

Employees shall have access to potable drinking water. MIN STOCK SHALL BE 32 OUNCES PER MAN PER HOUR. Where drinking water is not plumbed or otherwise continuously supplied it shall be provided in sufficient quantity at the beginning of the work shift to provide one quart per employee per hour for drinking for the entire shift. Employers may begin the shift with smaller quantities of water if they have effective procedures for replenishment during the shift as needed to allow employees to drink one quart or more per hour. The frequent drinking of water shall be encouraged.

  
•KEEP IT COOL
• You are more likely to drink water if it is cool than if it is warm. Be sure to keep your water cool
•Cool is not defined exactly but a rule of thumb that is used is that the water should be cool to the feel when drank.
•You should periodically check your water to make sure it staying this way throughout the day.
  
   Water Monitoring

  
•All employees shall include HEAT STRESS as a hazard on their Pre Task Cards


•Each employee shall write on the back of the pretask card the number of bottles of water consumed that shift.


•The supervisor shall initial this number and if it is inadequate shall counsel the employee to drink more water and note this counseling on the back of the                   pretask card.
  

Shade

(1) Shade shall be present when the temperature exceeds 80 degrees Fahrenheit. When the outdoor temperature in the work area exceeds 80 degrees Fahrenheit, the employer shall have and maintain one or more areas with shade at all times while employees are present that are either open to the air or provided with ventilation or cooling. The amount of shade present shall be at least enough to accommodate the number of employees on recovery or rest periods, so that they can sit in a normal posture fully in the shade without having to be in physical contact with each other. The shade shall be located as close as practicable to the areas where employees are working. Subject to the same specifications, the amount of shade present during meal periods shall be at least enough to accommodate the number of employees on the meal period who remain onsite.


  
IMPORTANT


•A normal posture while sitting does not include sitting on the ground. We need to provide them something to sit on.


•A connex CAN NOT be used as a shaded area. It is too hot in the direct sun. (A connex equiped with an air conditioner is permitted)


•Beneath Solar Panels on a Renewable Site is not allowed as a source of shade

  
•SHADE MUST BE MOVEABLE AS MUCH AS POSSIBLE


•The shaded area needs to be located as close to the work force as possible and should be designed so that it can be moved as the work force works in different areas of the project.


(2) Shade shall be available when the temperature does not exceed 80 degrees Fahrenheit. When the outdoor temperature in the work area does not exceed 80 degrees Fahrenheit employers shall either provide shade as listed above or provide timely access to shade upon an employee's request.

(3) Employees shall be allowed and encouraged to take a preventative cool-down rest in the shade when they feel the need to do so to protect themselves from overheating. Such access to shade shall be permitted at all times. An individual employee who takes a preventative cool-down rest (A) shall be monitored and asked if he or she is experiencing symptoms of heat illness; (B) shall be encouraged to remain in the shade; and (C) shall not be ordered back to work until any signs or symptoms of heat illness have abated, but in no event less than 5 minutes in addition to the time needed to access the shade.


High Heat Procedures

  
•E Light management and supervision shall implement high-heat procedures when the temperature equals or exceeds 90 degrees Fahrenheit. These                             procedures  shall include the following to the extent practicable:


(1) Ensuing that effective communication by voice, observation, or electronic means is maintained so that employees at the work sire can contact a supervisor when necessary. An electronic device, such as a cell phone or text messaging device, may be used for this purpose only if reception in the area is reliable.


(2) Observing employees for alertness and signs or symptoms of heat illness.

  
(3) Reminding employees throughout the work shift to drink plenty of water.


(4) Pre-shift meetings before the commencement of work to review the high heat procedures, encourage employees to drink plenty of water, and remind employees of their right to take a cool-down rest when necessary.


Acclimatization

  
•Close supervision of a new employee by a supervisor or designee for the first 14 days of the employee’s employment by the employer, unless the employee             indicates at the time of hire that he or she has been doing similar outdoor work for at least 10 of the past 30 days for 4 or more hours per day.

  
•Un-aclimated employees shall be assigned to work only with employees that can demonstrate they have completed this course.


•Un-aclimated employees shall wear a red hard hat tag for the first 14 days.


•The Red Hard Hat Tag must be removed after 14 days.


•Red Hard Hat tag employees must always work with at least one non-red hard hat tag employee at all times.


•Red Hard Hat tag employee may not work more than 8 hours in any one shift.

  
•It is critical that the “buddy” assigned to an un-acclimated employee be instructed that they are responsible for observing the un-acclimated employee                       carefully and ensuring they do not over exert or under hydrate.


•All supervisors are to be briefed daily on the number of un-acclimated employees that are on site and they are to monitor them all carefully.

  
RED TAG EMPLOYEES


•We will issue RED hard hat stickers to all Un-acclimated arrivals on the job site and this red sticker will remain on their hard hat for 14 days.


•At the end of the 14 day period we will remove the Red Sticker and replace with the normal color.
  
  

Training

  
Employee training. Effective training in the following topics shall be provided to each supervisory and non-supervisory employee before the employee begins work that should reasonably be anticipated to result in exposure to the risk of heat illness:

TOPICS
  
•The environmental and personal risk factors for heat illness, as well as the added burden of heat load on the body cause by exertion, clothing, and personal               protective equipment.
•  (b) The employer’s procedures for complying with all the requirements of this standard.
•  (c) The importance of frequent consumption of small quantities of water, up to 4 cups per hour, when the work environment is hot and employees are likely to        be sweating more than usual in the performance of their duties.

•  The importance of acclimatization.
•  (e) The different types of heat illness and the common signs and symptoms of heat illness.
•  (f) The importance to employees of immediately reporting to the employer, directly or through the employee’s supervisor, symptoms or signs of heat illness in       themselves, or in co-workers.

•The employer’s procedure s for responding to symptoms of possible heat illness, including how emergency medical services will be provided should they                   become necessary.
•  (h) The employer’s procedures for contacting emergency medical services, and if necessary, for transporting employees to a point where they can be reached         by an emergency medical service provider.
•  (i) The employer’s procedure for ensuring that, in the event of an emergency, clear and precise directions to the work site can and will provided as needed to            emergency responders. These procedures shall include designating a person to be available to ensure that emergency procedures are invoked when                             appropriate.


SUPERVISOR TRAINING

Prior to supervising employees performing work that should reasonably be anticipated to result in exposure to the risk of heat illness effective training on the following topics shall be provided to the supervisor:

  
•  (a) The information required to be provided by section (e) (1) above.
•  (b) The procedures the supervisor is to follow to implement the applicable provisions in this section.
•  (c) The procedures the supervisor is to follow when an employee exhibits symptoms consistent with possible heat illness, including emergency response                    procedures.
•  (d) How to monitor weather reports and how to respond to hot weather advisories.
  
  
Administrative Controls

  
Administrative controls are also used to help protect workers from heat stress.

•For example, heavy work—particularly work that requires workers to wear a lot of hot personal protective equipment (PPE)—might be scheduled for cooler           times of the year or cooler times of the day, like evening or early morning.

•More frequent breaks might be allowed, or breaks might be extended so that workers can rest away from hot conditions for longer periods. For example, in             very high temperatures, with high humidity, a demanding level of work, and a lot of heavy PPE, workers might be required to take a short break every hour or          so to prevent heat-related illness.


•Another administrative control to prevent heat stress is to allow workers sufficient time to become conditioned to working in hot conditions. Remember that it     can take 5 to 7 days to become acclimatized to hot conditions. As a result, new employees or those returning from vacation might be exposed to a hot                         environment for short periods at first, gradually increasing the length of exposure over the course of a week or so. 

  
–If temperatures are forecast to be in excess of 90 degrees F for the day the following SHALL be done:


•Each employee on the project shall be issued a bottle of water and an electrolyte powder packet at the beginning of stretch and flex.


•Each employee shall consume the bottle of water with the electrolyte powder in it before they leave stretch and flex.


•This will help ensure they at least have some electrolyte infusion before starting the work day.


–DO NOT ALLOW THE CONSUMPTION OF RED BULL OR OTHER ENERGY DRINKS
–DO NOT MAKE COFFEE OR TEAS WHICH CONTAIN CAFFEIN ON THE PROJECT WHEN TEMPERATURES EXCEED 98 degrees
  

•Reducing the physical demands on workers who are exposed to high temperatures and high humidity is also an effective way to reduce heat stress. For                       example, production requirements might be reduced or work schedules might be rearranged to allow workers sufficient rest time.


•Having relief workers on hand to fill in while another crew rests in a cool recovery area is another effective way to reduce heat stress and protect workers               from heat illness.


•In some cases, companies might limit the number of hours employees work in a hot environment each workday.


•And workers will be encouraged to pace themselves, being careful not to overexert.


•Never allow workers to work alone so that they can be observed. Teach them to use the buddy system.
  

PPE (Personal Protective Equipment)

  
Another important step that can be taken to reduce heat stress risks is to use PPE that has been designed specially for hot conditions. For example:

•Light hats that provide shade for the head, face, and neck when working outdoors;

•Portable water products that can be worn on the back or around the waist and accessed through a straw or tube system to provide adequate fluids;


•Reflective clothing that reduces the impact of radiant heat; or


•Systems that circulate air around the body, such as those used with full-body suits with air-supplied breathing systems.

  
•Brim extenders


•Sunblock


•Encourage the use of damp rags hung around the kneck
  

Medical Questions

  
–Ask employees if they have ever suffered from Heat Stroke in the past.
   •A person that has suffered heat stroke is more likely to suffer it again.
   •Keep a closer observation on persons that answer yes


–Observe employees when they come into work.
   •If they show signs if extreme fatigue, dehydration, alcohol consumption, etc. do not expose them high heat physical work


–Removing high-risk employees from hot working environments

  
REMEMBER THIS: IT IS BETTER TO SEND AN EMPLOYEE HOME IN THE MORNING THAN TO SEND THEM HOME IN AN AMBULANCE
  
Work Monitoring Programs

  
–Encourage Employees to do the following:


•Check heart rate at the beginning of a rest period.


•Check pulse 2.5 minutes after break starts.


•There heart rate should have begun to return to normal. If not this an indication of a problem.

  
•Work in teams and pairs and instruct the employees to watch each other for signs of heat stress disorders.


•Remind employees daily what to watch for.
  
  

Investigating Heat Related Illness

  
When all our programs and strategies to prevent heat-related illness fail and a worker succumbs to heat stress, we investigate the incident to determine what happened so that we can prevent another occurrence. When investigating heat-related incidents, we look at things such as:

•Events leading up to the incident—temperature, humidity, ventilation and air circulation, and sources of radiant heat;

•Work being done at the time of the incident—light, medium, or heavy;


•Length of time the employee was working before the incident—for example, days in a row worker had been doing the job, time of last break, and whether                   worker was properly acclimatized;


•Type of engineering and administrative controls being used;


•Type of PPE being worn; and


•Medical surveillance and worker monitoring that had been done prior to the incident.


BE SURE TO OBTAIN ALL OF THIS INFORMATION AND INCLUDE IT IN YOUR REPORT
  
SUMMARY

  
The importance of drinking enough fluids cannot be overemphasized when you work in hot conditions. Your body expels a great amount of fluid and salt when you work hard and sweat a lot. This fluid and salt must be replaced in order to prevent heat-related illness.

•So drink plenty of water all day.

•Drink electrolyte-balanced fluids such as sports drinks to help replace the salt that is lost through heavy sweating.


•Experts recommend drinking at least one cup—that’s about 8 ounces—of fluids every 15 to 20 minutes when working in hot conditions.


•They also suggest that you avoid drinking caffeinated beverages such as coffee and some sodas when you work in hot conditions. And they advise you to go              light or avoid alcohol after work. Caffeine and alcohol both contribute to loss of body water, which prevents your body from recovering properly from heat              stress and increases the risk of heat-related illness.

  
Here are the main points to remember from this session on working in hot conditions:

•Working in hot conditions can affect your health and safety.

•Make sure you understand the risks and the precautions you have to take to prevent problems.


•Know the symptoms of heat-related illness and the appropriate first-aid response for different degrees of heat stress.


•Use all available measures to reduce heat stress and keep safe and healthy when working in hot conditions.
  
  

  
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