Transcript Slide 1

Heat-Related Illness in the
Outdoor Environment
WAC 296-62-095
Employee Training for WAC 296-62-095. Taken largely from the Division of Occupational Safety
& Health revision 6-6-07 from Washington State Department of Labor and Industries
Presentation Outline
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Heat-related illness regulation
Types of heat-related illness
Signs and symptoms of heat-related illness
Environmental factors that contribute to the
risk of heat-related illness
Personal factors that may increase
susceptibility to heat-related illness
How to prevent heat-related illness
Emergency response procedures to heatrelated illness
Ultraviolet radiation
Heat Illness Regulations
WAC 296-62-095
Requires:
 Employers with one or more employees performing
work in an outdoor environment to implement
workplace practices designed to reduce or
eliminate risk of heat-related illness.
 Practices must be in writing, and must include:
 Accessibility to drinking water in sufficient quantity to
provide at least one quart per employee per hour
 Procedures to remove employees experiencing signs and
symptoms of heat-related illness from duty, to provide
sufficient means to reduce body temperature, and to
determine if medical attention is needed
 Employee training must be provided initially and
annually
Heat-Related Illness
Why is it important to know about heat illness?
Heat illness can effect anyone
Heat illness is dangerous
Heat illness can kill
Heat illness is preventable
NASA
Heat-Related Illness
Heat illness is:
Overheating of the body, potentially resulting in the
inability of the body to cool itself
Risk of heat-related illness occurs in:
 Any outdoor profession
 Temperatures greater than 75° or with
a 10° spike in temperature
 High humidity (approaching 80% or
greater)
Types of Heat-Related Illnesses
Types of heat-related illness:
 Heat Rash-red rash appears, often under clothing
 Heat Cramps-painful spasms usually in arms or legs,
results in abnormal posture or grasping of legs or
arms
 Heat Fatigue-impaired sensorimotor and/or mental
performance
 Heat Exhaustion (stress)-symptoms include
fainting, nausea, profuse sweating, headache,
disorientation, and irritability
 Heat Stroke-symptoms include convulsions, hot, dry
skin, loss of consciousness, and can be fatal
Heat Rash
Heat Rash
Red blister-like eruptions
Keep skin dry
Itching or prickling
Monitor for infection
Consult physician
Heat Cramps=Muscle Cramps
 A muscle cramp is an involuntarily and
forcibly contracted muscle or fibers of a
muscle that does not relax (i.e., a
muscle spasm that doesn’t relax is a
muscle cramp)
 Muscle cramps can last a few seconds,
a quarter of an hour, and occasionally
longer
 Muscle cramps can recur multiple times
 Muscle spasms and cramps are painful
 Heat cramps usually occur in the arm,
leg or stomach muscles
Heat Fatigue
Recognized when a person
exhibits impaired sensorimotor or
mental performance
Person may faint
Seek treatment ASAP before heat
fatigue progresses to heat
exhaustion
Heat Exhaustion and Heat Stroke
Take symptoms of both seriously
Untreated heat exhaustion can progress to heat
stroke & heat stroke can kill!
When the body can’t cool itself, body temp can
reach 106° in 10-15 minutes
Dehydration
Heat
Exhaustion
Heat
Stroke
Heat exhaustion or stroke can develop rapidly
or over a few days
Heat Exhaustion & Heat Stroke
Learn to Recognize the Signs & Symptoms
HEAT EXHAUSTION
 Dizziness or light-headed
 Weakness
 Extreme sweating
 Fatigue
 Red Face
 Mood changes, irritability or
confusion
 High pulse rate
 Pale, clammy skin/ face
 Headache
 Nausea/Vomiting
 Normal to slightly elevated
temperature
 Blurred vision
 Unsteady gait
 Fainting
HEAT STROKE
 Disorientation
 Erratic behavior
 Hot, dry skin/face that is flushed,
but not sweating
 Red face
 Mood changes, irritability,
agitation, or confusion
 Rapid pulse
 Chills/Shivering
 Restlessness
 Nausea/Vomiting
 High temperature (>104° F)
 Convulsions and/or seizures
 Loss of consciousness
 Coma
 May resemble a heart attack
Heat Stroke or Heat Exhaustion
Telling the Difference!
Mental confusion/disorientation occurs in
ALL heat stroke victims
Ask the person these 3 questions:
1. “What is your name?”
2. “What day is this?”
3. “Where are we?”
If the person can’t answer these
questions assume it is heat stroke!
How We-Stay Cool!
Gland (hypothalamus) in the brain controls body heat
Blood flows to skins surface to cool itself
Body sweats
Sweat evaporates off skin and has a cooling effect
on the body
2.6 million
sweat
glands in the
body
Monitor
Heat and Humidity
It is important to
monitor heat and
humidity values
each workday,
all day, in hot
and/or humid
weather
Environmental Risk Factors
Humidity and Heat
 Humidity (moisture in the air) interferes
with sweat evaporating from the skin thus
interferes with the cooling of the body
 The more humid it is, the less sweat can
evaporate, and the less body cooling
occurs, and the more chance of heatrelated illness
 Heat and humidity together greatly
increase the potential for heat-related
illness
Heat Index Warnings
Heat + Humidity = Heat Index
Heat Index
May feel
effects at
80°
Implement
controls at
90° or
before
General Effect of Heat + Humidity
with Prolonged Exposure &
Physical Activity
Caution
80-89
Fatigue possible
Extreme
Caution
90-104
Heat stroke, heat cramps, and
heat exhaustion possible
Danger
105-129
Heat stroke, heat cramps, and
heat exhaustion likely, and heat
stroke possible
Extreme
Danger
Heat stroke highly likely
Environmental Risk Factors
Heat & Humidity Chart: Heat Index
Implement
controls at
90° or
before
May feel
effects at
80°
Source: National Oceanic and Atmospheric Administration
Environmental Risk Factors
Direct Sun
More direct sun the greater the risk
Radiant Heat
From sun and other sources: transfers heat
energy through the air
Conductive Heat Sources
Transfers heat to worker by direct contact
with heat source (tools, machinery, etc.)
Limited Air Movement
Low or no wind
Radiant & Conductive Heat Sources
Hot equipment
 Engines add heat
Reflected heat
 From ground or
objects
Radiant heat may add 15° to Heat Index
Risk Factors
Physical Exertion
Produces Internal Heat in the Body
Consider:
What kind of work will be performed?
How hard is the work?
How long is the work task/period?
Photo credit: http://www.sullys.com.au/LawnMowing.htm
Risk Factors
Clothing Type and Amount
Clothing traps body
heat and inhibits
perspiration
Especially:
 Personal protective
equipment (PPE)
 Heavy clothing
 Multiple clothing
layers
 Dark-colored clothing
Personal Risk Factors
 Age, weight, and personal fitness
 Medical conditions
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Heart conditions
Diabetes
High blood pressure
Etc.
 Certain medications
Illness, fever or hangover
Personal Risk Factors
Medications
 Some medications can make a person more
sensitive to the effects of heat (many contribute
to body dehydration)
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Allergy medicines (antihistamines)
Cough and cold medicines
Blood pressure and heart medicines
Irritable bladder or bowel medicines
Laxatives
Mental health medicines
Seizure medicines
Thyroid pills
Water pills (diuretics)
Consult health care provider or pharmacist for more
information
Personal Risk Factors
Diet Matters
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No
No
No
No
sugary drinks
heavy foods
alcohol
caffeinated drinks
No Nicotine
 Constricts blood
Personal Risk Factors
Ditch that “Macho” Attitude!
Slow down, pace yourself, and take
breaks, especially on hot days!
Preventing Heat-Related Illness
Acclimatize
Acclimatization is Extremely
Important!
 People can collapse, become easily fatigued, make
mistakes, get into accidents, or develop heat-related
illnesses, if not properly acclimatized
 Many of us travel across the State, Nation, or over
seas for our work
 Those who live in, and are used to, a cooler climate,
should take special care when going to hot/humid
climates
Go Prepared!
Preventing Heat-Related Illness
Acclimatize
 Acclimate: plan in extra
time (several days) to
adjust to hot working
conditions
 Gradually build up
exposure time, and
adjust work routines, to
increase heat tolerance
Pay special attention to employees:
 That are new
 Just returning from being sick
 Are absent for more than 2 weeks
 Just moved from a cooler climate
 During heat-wave events
Preventing Heat-Related Illness
Information for Employees
WSU strives to prevent heat-related
illness by:
 Monitoring the work day weather &
tracking heat index
 Scheduling tasks to minimize physical
exertion on hot days
 Advising employees to pace themselves
 Encouraging frequent breaks on hot days
 Assigning workers a radio, pager, or cell
phone to keep in contact with base and
each other
 Providing annual heat-related illness
awareness training
 Providing CPR and First Aid training
Preventing Heat-Related Illness
Information for Employees
WSU strives to prevent heat-related illness by:
Providing:
 Appropriate PPE
 Cooling vests and bandanas
 Hats, sunglasses, etc.
 UVA/UVB rated sun glasses
 Sun screen (SPF 15 or above and
UVA/UVB effective)
 Easy access to water via water bottles,
coolers, hydration packs, and/or
transportation to base water supply
Preventing Heat-Related Illness
Work Smart
 Schedule the
hardest work for the
cooler parts of the
day
 Alternate heavy
work with light work
when possible
 Pace yourself
 Keep hydrated
Increase breaks when:
Conditions are very hot
Work requires high exertion levels
Protective clothing limits evaporative cooling
Preventing Heat-Related Illness
Work Smart
ESTABLISH A BUDDY SYSTEM!
Keep an
on co-workers for symptoms
of heat illness such as
crankiness and denial
Preventing Heat-Related Illness
Work Smart
Stay Cool!
Remove PPE
and excess
clothing during
breaks
Preventing Heat-Related Illness
Work Smart
Work in the shade or
out of direct sun
when possible
Wear proper clothing
 Light colored
 Light weight
 Natural fibers
 Hat with a brim
 Cooling vest or
bandanas may be
helpful in some cases
Preventing Heat-Related Illness
Stay Hydrated
Proper hydration is key to preventing heat illness
 It is important to drink water throughout the day or
dehydration results
 When dehydrated the amount of sweat that can be
produced decreases, and the body can’t properly
cool itself
 Do not wait for thirst before drinking water
 Water replaces body fluid lost by sweating
One quart or more of water over the
course of an hour may be necessary
when the work environment is hot,
and a person may be sweating more
than usual as they work
Preventing Heat-Related Illness
Stay Hydrated
 A quart of water is suggested because
the body can produce 1/2 gallon (2
quarts) of sweat per hour in hot
environments
 It is also important to incorporate
electrolyte-containing drinks in your
daily fluid intake
~1 cup every 15 minutes
Preventing Heat-Related Illness
Stay Hydrated
Drinking water sources:
 Be closeable & have a tap
 Clearly marked
 Suitably cool
 Individual cups
 Bottled water
 Hydration packs called
camelbacks-users sip
water through a tube
Photo credit: UC Davis
Hydration pack
Worker wearing hydration pack
STOP
All Activity if you become
Light-headed
Confused
Weak
Faint
Or have a pounding heart or trouble
breathing
Notify Supervisor immediately, if you or a
co-worker experience symptoms of heat-related illness
Take a Break and Rest in a cool place
Drink fluids
Loosen or shed unnecessary clothing
Lie Down
What You Can Do For Others
Treatment for Heat Exhaustion & Stroke
 Transport person to base, or to cooler, shaded area so
person can rest and lay down
 Get help on the way: call base and/or 911
 Do not leave person alone!
 Loosen and remove heavy clothing that restricts
evaporation and cooling
 If person is alert and not nauseated, provide fluids such
as cool water, juice, sports drinks, or non-caffeinated
soft drinks (~ cup every 15 minutes).
 Fan the person, spray or mist
with cool water, apply wet cloth to
skin
 Do not further expose the person
to heat this day. Have them rest
and continue to drink cool water
and electrolyte drinks
Get Help on the Way!
Call 911!
When person does not
feel better in about 15
minutes, or sooner, if
they show signs of heat
stroke
SECONDS
COUNT!
If You Suspect Heat Stroke
While waiting for medical help to
 Cool
the person using whatever methods available
arrive:
 Do not give person fluids to drink
 If emergency 911 medical personnel are delayed; call the
hospital emergency room for further instruction
Cooling Methods
 Immerse the person in a tub of cool water
 Place the person in a cool shower
 Spray them with cool water from a hose
 Sponge the person with cool water
 If the humidity is low, wrap person in a
cool wet sheet and fan them vigorously
 Apply ice packs under arms and to the
groin area
In Summary: Work Smart!
Stay hydrated! Drink water/fluids frequently!
Know the signs and symptoms of heat related
illnesses and take them seriously
Consider sports drinks when sweating a lot
Avoid alcohol, caffeinated drinks, and heavy
meals before or during work
Plan work tasks for heat relief
Pace yourself
Acclimatize
Wear appropriate clothing
Take regular breaks
Keep an eye on your buddy!
Photo credit: www.csao.org
Questions?
A Word About
Ultraviolet Radiation (UV)
 Ultraviolet radiation is energy from the sun
 Responsible for sunburn and skin cancers
 Three types of UV Rays come from the sun:
 UVA passes through the ozone layer, not blocked by
glass or most sunscreens, penetrate deep into the skin
 UVB only some absorbed in ozone layer thought to cause
most sunburns, block by glass and some sunscreen
 UVC is absorbed by the ozone layer
 Can track UV intensity levels by monitoring the UV
Index: www.epa.gov/sunwise/uvindex.html
 Enter zip code for UV index of interest
 Sign up for UV email alerts for your area
 The Index was developed by the National Weather
Service and the EPA
UV Index
The UV Index provides a daily (next-day) forecast by zip
code of the expected risk of overexposure to the sun.
The index predicts UV intensity levels on a scale of 1 to
11+.
The UV index takes into
account clouds and other
local conditions that affect
the amount of UV
radiation reaching the
ground
UV
Index
Exposure
Level
0 to 2
Low
3 to 5 Moderate
6 to 7
High
8 to Very High
10
11+
Extreme
www.epa.gov/sunwise/uvindex.html
Health Effects
of UV Over-Exposure
 Sunburn: is an inflammation of the skin that is
caused by UV radiation from the sun or UV tanning
lamps
Frequent UV ray overexposure effects:
 Skin Damage: may cause scarring, freckling, drying
out of, or premature wrinkling of the skin
 Skin Cancer: is directly linked to skin cancer
 Eye Damage: may burn the cornea, and increase the
risk of developing macular degeneration (a leading
cause of blindness), and cataracts
 Immune System Damage: potential to cause
immune system damage
Skin Cancer
 Skin cancer is the most common form of human
cancer (~ 1 million new cases occur annually)
 Approximately, half of all Americans who live to age
65 will develop skin cancer at least once
 Skin cancer refers to three different conditions. From
the least to the most dangerous, they are:
 Basal cell carcinoma
 Squamous cell carcinoma
 Melanoma most serious as can metastasize and
spread quickly throughout the body
 The most common warning signs of skin cancer is a
change in the appearance of the skin, such as a new
growth or a sore that will not heal
Recognizing Skin Cancer
A change in the size, shape, or color
of an existing mole
The appearance of a new, abnormal,
or "ugly-looking" mole.
The texture of an existing mole
changes and becomes hard, lumpy, or
scaly.
A mole may feel different and itch,
ooze, or bleed, but it usually is not
painful
The A-B-C-D’s of
Recognizing Melanoma
Watch moles for:
A Asymmetry -The shape of 1/2 doesn’t
match the other
B Border -The edges are ragged, notched,
or blurred
C Color -The color is uneven: Shades of
black, brown, and tan, or areas of white,
gray, red, or blue
D Diameter - There is a change in size
Melanoma causes ~75% of skin cancer deaths annually
1 in 4 people that develop melanoma are under 40
A
B
C
D
UV Protection Guidelines
Incorporate heat-related illness prevention
guidelines so not to develop a heat-related illness
while working in the sun, and in addition for UV
protection:
 Minimize sun exposure at midday (10AM to 4PM)
 Use broad spectrum sunscreen SPF15 of higher
(offers UVA & UVB protection)
 Reapply sunscreen every 2 hours
 Wear a broad brimmed hat (at least 2” to 3” brim
all around), and long sleeve shirts and pants
 Wear sunglasses that are labeled to block 99 to
100% of UVA and UVB radiation.
ANSI Z80.3 UV
No UV Label-No Buy!
ANSI Z87.1 Safety
Questions?