HEAT STRESS

1. HEAT STRESS Vincent J. Giblin, General President Phone: (304) 253-8674 Fax: (304) 253-7758 E-mail: hazmat@iuoeiettc.org 1293 Airport Road Beaver, WV 25813

2. This material was produced under grant number 46C5-HT16 from the Occupational Safety and Health Administration, U.S. Department of Labor. It does not necessarily reflect the views or policies of the U.S. Department of Labor, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

3. RECENT HEAT RELATED DEATHS • Korey Stringer 7-31-01 • 27 Yrs Old 6’3” 335 lbs • Eraste Autin 7-25-01 • 18 Yrs Old 6’2” 250 lbs • Preston Birdsong 8-13-00 • 18 Yrs Old 5’11” 190 lbs Operating Engineers National Hazmat Program

4. COMMON FACTORS(Worker vs. Athlete) • Protective clothing • Focus on task at hand • Job security concerns • Desire to succeed • Desire to be accepted • Machismo • Peer pressure • Delayed thirst mechanism Operating Engineers National Hazmat Program

5. U.S. HEAT STROKE STATS • At least 300 deaths/year • 7421 deaths from 1979-1998 • 1700 deaths in 1980 alone • Causes more deaths annually than hurricanes, lightning, tornadoes, floods, and earthquakes combined • 18 high school and college football player deaths since 1995 Operating Engineers National Hazmat Program

6. PHYSIOLOGICAL RESPONSES TO OVERHEATING English Translation: What happens when you get too dang hot

7. “TOO DANG HOT RESULTS” • Excessive sweat loss results in dehydration • The body loses its ability to cool • Increased blood flow to skin causes decrease in organ function Operating Engineers National Hazmat Program

8. HEAT-RELATED ILLNESSES • HEAT CRAMPS • HEAT EXHAUSTION • HEAT STROKE Operating Engineers National Hazmat Program

9. HEAT CRAMPS • Caused by excessive loss of electrolytes • Early warning sign of heat stress • Painful cramps usually in legs or abdomen • Stop activity, hydrate, rest in cool place • Get medical attention if condition continues Operating Engineers National Hazmat Program

10. HEAT EXHAUSTION • The body’s response to excessive water and electrolyte loss • Stop activity and seek treatment immediately Operating Engineers National Hazmat Program

11. HEAT STROKE • The body’s cooling mechanism shuts down • 50% that reach the heat stroke stage die even with medical attention Operating Engineers National Hazmat Program

12. HEAT EXHAUSTION Skin is pale Excessive sweating May faint but usually conscious Headache Nausea and vomiting Blurred vision Dizziness HEAT STROKE Skin is red No sweating Unconscious or incoherent LIVE OR DIE? Operating Engineers National Hazmat Program

13. HEAT EXHAUSTION Call 911 Rest in cool place Loosen and remove unnecessary clothing Shower or sponge with cool water HEAT STROKE Call 911 Immediate, aggressive, effective cooling DO NOT give anything by mouth Transport to hospital TREATMENT Operating Engineers National Hazmat Program

14. Poor nutrition Poor physical condition High and low % body fat Previous heat illness Lack of acclimatization Over 40 Illness (diabetes, asthma) Pregnancy Diet plans HUMAN RISK FACTORS Operating Engineers National Hazmat Program

15. ENVIRONMENTAL RISK FACTORS • Air temperature • Direct sunlight • Radiant heat • Humidity • Little air movement Operating Engineers National Hazmat Program

16. JOB RISK FACTORS • Work intensity • Work duration • Location (roof, road, enclosure) • Clothing (weight, impermeability) • Respiratory protection Operating Engineers National Hazmat Program

17. WORKER RESPONSIBILITY • Follow instructions of IH and health care professionals • Be watchful for symptoms (self and others) • Properly hydrate (before, during, after) • Get adequate rest • Avoid alcohol, unnecessary medication, and caffeine Operating Engineers National Hazmat Program

18. Ensure that environmental conditions are monitored Adjust work practices as necessary Be watchful for signs of overexposure Know workers medical history Assure workers are properly trained Conduct pre and post job safety meetings Assure that affected workers receive treatment MANAGEMENT RESPONSIBILITY Operating Engineers National Hazmat Program

19. MONITORING • Environmental monitoring • WBGT (heat index= temp+humidity+radiant) used for guidance in establishing work/rest ratio • Personnel monitoring • Oral thermometer • Ear probe • R*&%$! Thermometer • Core Temp • Pulse rate • Blood pressure Operating Engineers National Hazmat Program

20. COOLING WEAR • Traditional ice vests • Chem-pack vests, headbands, & bandanas • Active cooling garment (water circulating) • SAR and PAPR with active cooling systems • New material development (breathable, lighter weight, waterproof) Operating Engineers National Hazmat Program

21. COLD STRESS Hypothermia

22. Cold Stress (Hypothermia) • Acute problem resulting from prolonged cold exposure and heat loss • “Hypo” (too little) “Thermia” (heat) • 750 deaths/year in USA • Generally doesn’t present the same level of danger as heat stress • Does not occur as quickly • Workers will simply come in out of the cold

23. MAJOR CAUSES • Cold Temperatures • 41 degrees F is cold enough with other contributing factors • Improper clothing and equipment • Wetness • Sweating, contact with water • Water conducts heat away from the body 25 Xs faster than air

24. Contributing Factors • Fatigue • Dehydration • Hunger • Alcohol intake

25. SYSTEMIC Hypothermia LOCALIZED Frostnip Frostbite Trench Foot Cold Stress Hazards

26. Signs and Symptoms • Hypothermia • Body temp <95 degrees F • Euphoria • Slow weak pulse • Slurred speech • Shivering • Unconsciousness

27. Frostnip/Frostbite Itching/burning/numb Skin color change White Grayish yellow Reddish violet Black Trench Foot Severe pain/itch/tingle Swelling Blisters Signs and Symptoms

28. Hypothermia Move to warm area Remove wet clothing Modest external warming Blankets/heat packs Drink warm sweet fluids (non-caffeinated) Transport to hospital Frostnip/Frostbite Move to warm area External warming Warm water Drink warm sweet fluids (non-caffeinated) Treat as burn (do not rub) Transport to hospital First Aid

29. Body Response Mechanisms • Vasoconstriction • Blood vessel constriction • Reduces heat loss/makes skin better insulator • Shivering • Increases body temp as vasoconstriction fails • **NEITHER ARE AS EFFECTIVE AS SWEATING AND ACCLIMATION ARE FOR HEAT STRESS

30. Behavior Is The Key! • Behavior is the primary protection factor for cold stress prevention • Increase clothing insulation • Increase activity • Seek warm location • Get the H$!! out of there

31. Cold Stress Solutions • Engineering Controls- Warming shelters, spot heating (i.e. hand warmers), minimize air movement (shielding) • Work Practices- fluid replacement, change wet clothes immediately, buddy system • Administration Controls-work/rest cycles, warm period work, allow for productivity reductions • PPE

32. Clothing Tips • Dress in Layers • Add or remove for comfort • Allows free movement and dexterity • Layer closest to skin should be “water vapor permeable” • Wicks away moisture, allows evaporation, prevents accumulation

33. This material was produced under grant number 46C5-HT16 from the Occupational Safety and Health Administration, U.S. Department of Labor. It does not necessarily reflect the views or policies of the U.S. Department of Labor, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

34. END • This publication was made possible by grant numbers 5 U45 ES06182-13 AND 5 U45 ES09763-13 from the National Institute of Environmental Health Sciences (NIEHS), NIH. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIEHS, NIH.