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Solution: Heat Stress Program

A heat stress program outlines the steps to limit heat stress and reduce the risk of heat-related illnesses associated with working in high temperatures and humidity.

Description:

Working in high temperatures and high humidity for an extended period can result in heat-related illnesses. Implementing a comprehensive heat stress program can have a positive impact on safety and productivity. Ensuring adequate hydration, rest and cooling are part of a heat stress program and help to lower risks for heat stress and other heat-related issues.

A heat-related illness prevention program should include:

1) the individual who will be responsible for ensuring the program is in place (e.g., supervisor, foreman, safety coordinator, crew leader, etc.),

2) the heat-related hazards and workers at risk,

3) ways to protect workers and the resources required (e.g. water, access to a shaded area, etc.),

4) training for workers and supervisors on how to identify, prevent, and respond to heat-related illnesses, and

5) steps for aiding workers suffering from a heat-related illness including emergency preparations for possible heat stroke cases.

Specific actions:

  • Check the extended weather forecast. Call or visit the National Weather Service at http://www.weather.gov/ to plan for upcoming work and prior to the start of each workday to ensure that adequate plans are in place to protect workers. You can also receive weather alerts on your cell phone or computer through http://weather.weatherbug.com/?stick=1 or the National Weather Service at http://www.erh.noaa.gov/er/iln/WEA/wireless_emergency_alert.php.
  • Conduct worker and supervisor training on how to prevent and identify heat-related illnesses, and provide regular reminders.
  • If possible, schedule work activities during cooler times of the day and shade the work area.
  • Acclimatize workers to working in a hot work environment. With no recent exposures to heat stress, acclimatization may require up to two weeks of gradually increasing heat stress exposure.
  • Make sure all workers know where to go for water and shade. Locate water and shaded areas or air-conditioned areas for breaks as close as practical to where the work is being performed.
  • Identify the quantity of drinking water and ice, and the number of disposable cups that will be needed for the shift. Remind workers to drink water and the amount they should drink – OSHA recommends drinking small amounts of water before workers become thirsty or “at least one pint of water per hour in moderately hot conditions… 6 ounces or a medium-sized glass-full every 15 minutes.” Keep water containers in sanitary conditions.
  • Increase the frequency of rest and water breaks to prevent dehydration and over-heating during heat waves or days of excessive heat (when the temperature equals or exceeds 95 degrees Fahrenheit).
  • Keep a thermometer on the job and check it hourly to ensure that preventative measures are taken if there are unexpected changes in temperature and weather conditions.
  • Encourage workers to wear light-colored, loose-fitting, breathable clothing (e.g. cotton), and increase the monitoring of those workers using personal protective equipment (PPE) that covers the body or face.
  • Ensure that an emergency response plan is in place and includes: who will respond, steps for handling a worker with a heat-related illness (e.g. who will stay with the person, who knows first-aid, etc.), a map of the site and directions for emergency medical services, and how to address potential language barriers. Heat stroke can pose an imminent threat to life and health, so on remote or difficult to access construction sites the plan should address air evacuation or rapid ambulance access.

Administrative Controls

3M QUESTemp° 46 Heat Stress Monitor

 

 

 

 

 

 

 

 

 

 

 

  • Cost: $4,500
  • Monitors: Fahrenheit and Celsius scales, wet bulb, dry bulb, globe, WBGT indoor, WBGT outdoor, relative humidity, heat index, Humidex, air flow
  • Weight: 2.6 pounds
  • Features: multiple data logging intervals, optional remote sensors for up to (3) simultaneously monitored areas, air velocity sensor, stay time/work rest cycles based on the ACGIH TLV Handbook, rechargeable battery
  • Dimensions: 9.2 inches by 7.2 inches by 3 inches

SafetySpot Personal Temperature Monitor

 

 

 

 

 

 

  • Cost: $100 (verified 10/2013)
  • Body Mount (2 locations): medical grade adhesive to carotid artery just below the ear and temporal artery just above the eyebrow (see diagram from manufacturer).
  • Weight: less than 1 ounce
  • Features: aluminum case, one year battery life from activation of the monitor, water resistant, accurate to within 0.5 degrees Fahrenheit
  • Alarm: if body temperature rises above 103 degrees for more than 45 seconds an audible alarm and a flashing red LED will activate until the temperature returns below 103 degrees Fahrenheit
  • Approximate size: diameter of a quarter and thickness of 3 quarters

Risks Addressed:

Heat-related illnesses are caused by working in high temperatures, high humidity and/or direct sun for an extended period of time. Thousands of outdoor workers suffer from heat-related illnesses each year. In addition, many workers die from heat induced illnesses each year. In 2010 alone, 30 workers died from heat stroke.

In hot environments, the body releases excess heat to maintain a stable internal temperature by circulating blood to the skin and through sweating. If the body cannot get rid of excess heat, it will store it and the body's core temperature rises and the heart rate increases. When the body continues to store heat, the person begins to lose concentration and has difficulty focusing on a task, may become irritable or sick, and often loses the desire to drink water. Then, fainting, and even death, can occur if the person does not cool down (OSHA Fact Sheet).

Heat stress can lead to many different conditions, including, but not limited to, heat stroke, heat exhaustion, heat syncope, heat cramps, and/or heat rash. Prevention of heat stress in workers is important (CDC Heat Stress).

Heat-related illnesses are caused by working in high temperatures, high humidity and/or direct sun for an extended period of time. Thousands of outdoor workers suffer from heat-related illnesses each year. In addition, many workers die from heat induced illnesses each year. In 2010 alone, 30 workers died from heat stroke.

In hot environments, the body releases excess heat to maintain a stable internal temperature by circulating blood to the skin and through sweating. If the body cannot get rid of excess heat, it will store it and the body's core temperature rises and the heart rate increases. When the body continues to store heat, the person begins to lose concentration and has difficulty focusing on a task, may become irritable or sick, and often loses the desire to drink water. Then, fainting, and even death, can occur if the person does not cool down (OSHA Fact Sheet).

Heat stress can lead to many different conditions, including, but not limited to, heat stroke, heat exhaustion, heat syncope, heat cramps, and/or heat rash. Prevention of heat stress in workers is important (CDC Heat Stress).

A 2011 study of 37,816 Thai workers examined the relationship between occupational heat stress and kidney disease. After analyzing data from both 2005 and 2009, the study found that more men were exposed to heat stress than women. Men exposed to extended periods of heat stress were 2.22 times more likely to develop kidney disease than those who did not experience such conditions. In addition, men 35 years old and older experienced a 2.2% chance of developing kidney disease when exposed to heat stress while those not exposed experienced a 0.4% chance. Overall, among workers in Thailand’s tropical climates, exposure to heat stress had a direct link to kidney disease (Tawatsupa, 2012).

Although it is universally recognized that maintaining adequate levels of hydration to prevent heat stress is important, many workers and supervisors ignore the facts and continue to demonstrate poor levels of hydration in the work field. Strategies to help promote good hydration are often neglected. Recent studies have shown a consistent pattern of poor hydration in workers employed in industries where environmental heat stress is a common problem. An Australian research study tested workers by administering a urine test during working hours. The results showed that greater than 70% of 710 workers indicated poor hydration, and 51% showed hydration poor enough to put the workers at high risk for heat related illnesses (Miller, 2009).

The American Conference of Governmental Industrial Hygienists (ACGIH) assigned heat a Threshold Limit Value (TLV) based on time-weighted averages (TWA) of Wet-Bulb Globe Temperature (WBGT). WBGTs are not the same as standard temperature readings because they integrate the effect of humidity through a wet bulb reading and radiant heat with a black globe reading. The TLVs are ratios of work to rest needed for different WBGT values. For example, within every hour worked in the cycle, the percentage of time to work during that hour at temperatures at or above the TLV is shown in the first column. WBGT values must be adjusted for the type of clothing worn (ACGIH, 2013). The TLV booklet goes into great detail about heat stress prevention, measurement and control. It can be purchased at: http://www.acgih.org/store/.

Screening Criteria for TLV for Heat Stress Exposure

Allocation of Work in a Cycle of Work and Recovery

TLV (WBGT Values in Degrees Fahrenheit)

Light1

Moderate2

Heavy3

Very Heavy4

75-100%

87.8

82.4

--

--

50-75%

87.8

84.2

81.5

--

25-50%

89.6

86.0

84.2

82.4

0-25%

90.5

86.9

86.9

86.0

 

1 Sitting with light manual work with hands or hands and arms, and driving. Standing with some light arms work and occasional walking.
2 Sustained moderate hand and arm work, moderate arm and leg work, moderate arms and trunk work, or light pushing and pulling. Normal walking.
3 Intense arm and trunk work, carrying, shoveling, manual sawing; pushing and pulling heavy loads; and walking at a fast pace.
4 Very intense activity at fast to maximum pace.


How Risks are Reduced:

The risk of heat-related illness and injury is reduced by increasing management and worker awareness of the hazards, and ensuring that water, shade and more frequent rest periods are provided.

In 2010, researchers at The Jikei University School of Medicine conducted a study to determine the effect of an oral rehydration solution versus a beverage of choice on fatigue for manual laborers on a hot day. The study included 153 cargo handlers at Tokyo International Airport during two summer day shifts with a wet bulb temperature of 30° Celsius. The study concluded that fatigue was significantly reduced while consuming the solution compared to drinks of choice, most often coffee or tea. Compared with commercially available sports drinks, oral rehydration solutions (ORS) are high in sodium, low in sugar, and have an osmotic pressure that is lower than that of plasma. The oral rehydration solution also helps to prevent heat stroke as it provides necessary electrolytes while working in hot settings (Ishikawa, 2010).

There should be enough cool, potable water available for each employee on the jobsite to drink at least one quart per hour until the water supply is replenished. For example a crew of five workers would need a minimum of 40 quarts, or 10 gallons, of water for an 8-hour work shift. The water must be stored in locations accessible to all employees. Employers should also provide a container which the employees can keep with them and refill from the available water supply. After air temperature exceeds 90°F, ice should be on hand to cool the drinking water onsite (Cal-OSHA Heat-Related Illness Guide).


Quality of Evidence (Risk Reduction):

  • Independent published studies have found a risk reduction.
  • Safety and health experts believe there is a risk reduction.

Quality of Evidence Explanation (Risk Reduction):

The Occupational Safety and Health Administration (OSHA), National Institute for Occupational Safety and Health (NIOSH), Center for Disease Control (CDC), other government agencies, and industry and employee groups acknowledge the hazards associated with exposure to high temperatures and humidity. The ability to reduce heat-related illnesses and injuries by taking precautions such as water, rest and shade have been documented in government publications, health hazard evaluations and by the research and medical communities.


Effects on Productivity:

Studies have documented the impact of heat-related illnesses on productivity. According to California’s largest provider of workers compensation insurance, “[r]ecognizing the warning signs and symptoms of heat-related illnesses and using preventive and control measures can reduce the frequency and severity of heat illness while increasing worker productivity (Preventing Heat Related Illnesses)."


Quality of Evidence (Effects on Productivity):

  • Independent published studies have found an increase in productivity.
  • Safety and health experts believe there is an increase in productivity.

Quality of Evidence Explanation (Effects on Productivity):

The Department of the Army and Air Force, in its 2003 “Technical Bulletin: Heat Stress Control and Heat Casualty Management,” noted that “[h]eat stress slows reaction time and decision times. Routine tasks are done more slowly. Errors of omission are more common. Vigilant task performance will degrade slightly after 30 minutes and markedly after 2 to 3 hours.”

A study examined the medical and lost productivity costs of heat related illnesses and injuries and found support for “the premise that heat illness/injury incurs costs not only in terms of medical treatment and absenteeism but also in terms of the lowered productivity of presenteeism [productivity that is lost when an employee is not working at full capacity because of a heat-related illness, or other type of illness or injury].” (Corso, 2004)

Presenteeism “is a source of enormous productivity loss that, when ‘dollar denominated,’ costs employers more than medical care benefits.” (Sullivan, 2004)


Additional Considerations:

Engineering controls are always superior to administrative controls and personal protective equipment, where it is feasible to directly control the hazard. Engineering solutions to consider, especially for low humidity conditions, include down-blast ventilation or fans to increase evaporative cooling, evaporative cooling units for rest stations or stationary work locations, water misting or fogging for rest stations. Semi-portable or permanent air conditioning of vehicle cabs or rest locations may also be feasible, and will be more effective in high humidity conditions.

For very high heat conditions, such as work in impervious protective suits, cooling vests using ice or chilled water may reduce body core temperatures. Where supplied breathing air is provided, cyclones or other devices are available which chill the breathing air or air for positive pressure protective clothing.

Employers should provide training to workers so they understand what heat stress is, how it affects their health and safety, and how it can be limited.


Contributors:

Eileen Betit - CPWR - The Center for Construction Research and Training.  Dan Anton, PT, PhD, ATC – Eastern Washington University.  Andrew Kingston, Michael R. Cooper and Bruce Lippy – The Lippy Group


Hazards Addressed:

 

Availability

3M QUESTemp 46 Heat Stress Monitor
For purchasing information, visit SKC Inc. or contact 1-800-752-8472 skcinc@skcinc.com

SafetySpot Personal Temperature Monitor
For purchasing information, visit Sport and Industry Safety Devices, LLC or contact 1-434-361-0305

 

Return on Investment

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