Recognizing and Preventing Heat-Related Hazards as Temperatures Rise

Employers must work to protect workers from heat-related illnesses during the hot summer months.

• By Sydny Shepard
• Mar 01, 2020

In the dead of winter, when the sky is dark, the wind is chilling and the clouds are heavy, we are all thinking the same thing: “I can’t wait for the sun to come out and for summer to be here.” While thinking of the summer heat can help to warm up our chilly bones in the winter, rising temperatures can be quite detrimental to a worker’s health if not approached correctly.

The risks of summer-related illnesses such as heat rash, heat cramps, heat exhaustion and heat stroke are increased significantly when a person is introduced to extreme heat while engaged in strenuous activities. This extreme heat can also increase a worker’s risk of injury, as it may result in sweaty palms, fogged-up safety glasses, dizziness, or reduced brain function responsible for reasoning ability. Other injuries may also occur due to hot environments around workers such as burns from hot surfaces, steam or fire.¹

Between 1992 and 2017, more than 815 workers were killed and 70,000 were seriously injured by heat stress between 1992 and 2017, according to the Bureau of Labor Statistics. This begs the ever-important question: How can employers address heat dangers and keep workers safe?

Be on the Lookout
Before understanding the steps needed to address heat-related illnesses, you must first be aware of what kinds of injuries and illnesses can occur in the summers’ extreme heat. Like mentioned before, the chances of a worker suffering from heat rash, heat cramps, heat exhaustion and heat stroke are significantly higher when the temperature begins to soar. Here are the most common heat illnesses, their symptoms and how to treat them.

Heat Rash. Heat rash is generally misunderstood to be an affliction for babies, but heat rash can affect adults, too, especially during hot, humid weather. Heat rash develops when blocked pores, or sweat ducts, trap perspiration under your skin.

Symptoms. Adults usually develop heat rash in skin folds where clothing causes friction. Symptoms include superficial blisters and can even present as deep, red lumps. Some forms of heat rash can feel extremely itchy.

Treatment. Heat rash will usually clear on its own by cooling the skin and avoiding exposure to the heat that caused it. If symptoms such as increased pain, swelling, redness, or warmth extend for longer than a few days reach out to a doctor for specialized treatment.²

Heat Cramps. Heat cramps are painful, brief muscle cramps where the muscles may spasm or jerk involuntarily. These cramps can begin during the activity in the heat, or may start several hours later. Muscles that are most susceptible to heat cramps are those that are usually fatigued by heavy work such as calves, thighs and shoulders.

The exact cause of heat cramps is unknown, but medical professionals are able to boil it down to a chemical imbalance in the muscles–usually related to electrolytes. Electrolytes include various essential minerals, such as sodium, potassium, calcium and magnesium. They are involved in the chemical reactions of your muscles, and an imbalance can cause issues.

Symptoms. Someone who is experiencing heat cramps will feel muscle spasms that are painful, involuntary, brief, intermittent and self-limited (meaning, they go away on their own).

Treatment. To treat heat cramps, begin with rest and a sports drink that includes electrolytes and salt or drink cool water. You can make your own salt solution by mixing a quarter to a half teaspoon of salt into a quart of water.³

Usually, heat cramps will dissipate on their own, but if you begin to see conditions worsen and the patient becomes dizzy, nauseous, experiences shortness of breath and a fast heartbeat, you should see a doctor. Heat cramps often accompany a more serious heat-related illness: heat exhaustion.

Heat Exhaustion. Heat exhaustion is a result of your body overheating and can cause heavy sweating, rapid pulse, dizziness and low blood pressure upon standing. Causes of heat exhaustion include exposure to high temperatures, particularly when combined with high humidity and vigorous physical activity.

Symptoms. Without prompt treatment, heat exhaustion can quickly lead to heat stroke, a life-threatening condition, so it is important to know the signs of someone who is likely suffering from heat exhaustion. Signs and symptoms may develop suddenly or over time and include cool, moist skin with goose bumps in the heat, heavy sweating, faintness, dizziness, fatigue, weak and rapid pulse, low blood pressure upon standing, headache, nausea and muscle cramps.

Treatment. If you see someone who might be experiencing heat exhaustion, instruct them to halt all activity and rest, move to a cooler place and drink cool water or a sports drink.

A doctor should be contacted if signs and symptoms worsen or if they don’t improve within one hour. A patient will need immediate cooling and urgent medical attention if their core body temperature reaches 104 Fahrenheit or higher. Those who exhibit confusion, agitation, loses consciousness or is unable to drink must also be taken to see a medical professional as soon as possible.⁴

Heat Stroke. Heat stroke is the most serious form of heat injury and can occur if your body temperature rises to 104 Fahrenheit or higher. Heat stroke requires emergency treatment, and if left untreated, can quickly damage the brain, heart, kidneys and muscles. Damage to internal organs worsens the longer treatment is delayed, increasing your risk of serious complications or death.

While anyone can develop heat stroke, there are several factors that can increase the risk of illness such as age, exertion in hot weather, a lack of cool air or air conditioning, certain medications and certain health conditions.

Symptoms. Heat stroke symptoms include high body temperature, altered mental state or behavior, alteration in sweating, nausea and vomiting, flushed skin, rapid breathing, racing heart rate and headache.

Treatment. Someone who is suffering from a heat stroke must take immediate action to cool down their body while waiting for emergency treatment. To do this, move to shade or indoors, remove excess clothing and cool with whatever means available (put in a cool tub of water or a cool shower, spray with a garden hose, sponge with cool water, fan while misting with cool water, or place ice packs or cold, wet towels on the person’s head, neck, armpits and groin).⁵

Prevention of Heat-Related Illnesses
Heat stroke, or any other heat-related illness, can be prevented. Take these steps to reduce the risk of illness.

• Wear loose-fitting, lightweight clothing that allows your body to cool properly. Try not to wear excess clothing or clothing that fits too tightly.
• Be sure to protect against the sun. Sunburn affects your body’s ability to cool itself, so be sure to always wear sunscreen with an SPF of at least 15 and apply it generously, reapplying every two hours.
• Drinking plenty of fluids and staying hydrated will help your body sweat and maintain a normal body temperature.
• If you can’t avoid strenuous activity during hot weather, try to schedule physical labor for cooler parts of the day, such as early morning or evening.
• If you are taking medications or have a condition that increases your risk of heat released problems, avoid the heat and act quickly if you notice symptoms of overheating.

NIOSH Suggested Standards
The National Institute for Occupational Safety and Health has developed criteria for a possible federal standard for occupational exposure to heat and hot environments, specifically covering recommended engineering and administrative controls and person protective equipment. The NIOSH suggested standards include:

• Reducing physical demands of the work by using powered assistance for heavy tasks.
• Helping workers acclimate to high temperatures by gradually increasing exposure to hot conditions over seven to 14 days.
• Scheduling new workers for not more than 20 percent of the usual duration of work in a hot environment on the first day with no more than a 20 percent increase each day.
• Encouraging water intake at frequent intervals to prevent dehydration—one cup every 15 to 20 minutes.
• Providing shade and/or air-conditioned space nearby.
• Monitoring workers for complicating conditions such as alcohol ingestion, diarrhea and low-grade infections.
• Providing cooled air, cooled fluid or ice-cooled clothing and reflective clothing or aprons for workers in hot industrial environments.

Satisfying OSHA
The Occupational Safety and Health Administration currently issues citations to employers based on the general duty clause, a part of federal safety law that requires employers to maintain a safe workplace even in the absence of regulations and standards targeting specific safety practices. There is, however, no standard for heat exposure from OSHA. (State OSHA plans in California, Minnesota and Washington do have standards for heat exposure.)

An employer with workers who could be exposed to hot environments must establish a heat illness prevention program to satisfy OSHA.6 The agency has said that such a program should include:

• Training all employees and supervisors on heat illness prevention.
• Providing enough fresh water for each employee and encouraging them to drink.
• Providing access to shade and encouraging employees to take a cool-down rest in it; they should not wait until they feel sick to cool-down.
• Developing and implementing written procedures, specific to the worksite, for heat illness prevention, including plans on how to handle medical emergencies and steps to take if someone shows signs of a heat illness.
• Planning for emergencies and training workers on prevention, including any of the previous written procedures.
• Documenting any and all training, discussions and emphasis on heat-related prevention, training and safety.

While there is no specific standard for heat, employers nevertheless have a duty to protect their workers from recognized serious hazards in the workplace, including heat-related hazards. OSHA’s message is “Water. Rest. Shade.” Employers should work to ingrain this slogan into their workers’ minds when working in the hot summer months.

REFERENCES
¹ https://www.cdc.gov/niosh/docs/2016-106/pdfs/2016-106. pdf?id=10.26616/NIOSHPUB2016106   
² https://www.mayoclinic.org/diseases-conditions/heat-rash/symptomscauses/syc-20373276
³ https://www.webmd.com/fitness-exercise/heat-cramps
⁴ https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/ symptoms-causes/syc-20373250    
⁵ https://www.mayoclinic.org/diseases-conditions/heat-stroke/symptomscauses/syc-20353581  6. https://www.osha.gov/SLTC/heatstress/standards.html

This article originally appeared in the March 2020 issue of Occupational Health & Safety.