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heat stress compliance

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Employers should manage occupational heat stress through a written heat illness prevention program that covers hazard identification, responsibilities, training, acclimatization, hydration, monitoring, first aid, and emergency response. Enforcement agencies evaluate these programs case by case, and recognized feasible controls include training, acclimatization, weather monitoring, work scheduling, shaded or cool break areas, drinking water, symptom reporting, first aid, and emergency procedures. [1] [5]

  • Identify heat hazards by evaluating temperature, humidity, radiant heat, sun exposure, air movement, workload, clothing/PPE, and personal risk factors.
  • Use recognized assessment tools such as WBGT, heat index, the OSHA-NIOSH Heat Safety Tool App, thermometers/hygrometers for indoor spaces, and weather alerts.
  • Increase controls when full sun, high humidity, limited air movement, heavy exertion, or bulky/impermeable PPE are present, because these materially increase heat strain.

[3] [4] [18] For compliance, there is no single federal OSHA heat standard that applies broadly to all workplaces, but employers remain responsible for protecting workers from recognized heat hazards under the general duty to provide a workplace free of serious hazards. State-plan requirements may be more specific. For example, Oregon requires training before work reasonably anticipated to expose employees to a heat index of 80°F or more, water and shade/cooling access at 80°F or above, and additional high-heat practices above 90°F. California indoor heat rules require measurement and recording when thresholds are reached and provision of cool-down areas below 82°F. Employers should follow the most stringent rule that applies in their jurisdiction and industry. [5] [6] [16] [9]

  • Provide potable, suitably cool drinking water at no cost and as close as practicable to the work area and cooling area.
  • Plan for intake of up to 32 ounces per hour in hot work, typically by encouraging small, frequent drinks.
  • A practical field target is about 1 cup every 15 to 20 minutes during moderate activity in hot conditions.
  • Do not encourage overdrinking; excessive fluid intake can create a medical emergency from low blood sodium.
  • Discourage alcohol and limit caffeinated beverages when they contribute to dehydration risk.

[6] [8] [4] [10]

  • Use a structured acclimatization plan for new and returning workers and during heat waves or abrupt hot-weather changes.
  • For new workers, begin at no more than 20% heat exposure or workload on day 1 and increase by no more than 20% each day.
  • For experienced workers returning to hot work, a common schedule is 50% on day 1, 60% on day 2, 80% on day 3, and 100% on day 4\.
  • Closely observe workers during the first 4 to 14 days, when risk is highest.

[8] [10] [14] [9]

  • Modify schedules to perform heavier work during cooler parts of the day and reduce nonessential hot work during peak heat.
  • Use work/rest cycles, rotating crews, split shifts, extra staffing, and overtime limits as needed.
  • Provide shaded, ventilated, or air-conditioned recovery areas close to the work area; if shade is infeasible, implement equivalent cooling measures.
  • For indoor work, provide at least one cool-down area and keep it below 82°F where required.

[10] [13] [6] [9]

  • Train all affected employees and supervisors before hot work and at least annually where required.
  • Cover environmental and personal risk factors, effects of exertion and PPE, hydration, acclimatization, signs and symptoms, first aid, emergency response, reporting procedures, and employee rights.
  • Maintain written or electronic training records where required by rule.

[2] [6] [16] [2]

  • Monitor conditions and workers continuously during hot work using a competent person, supervisor checks, and a buddy system.
  • At higher heat, maintain reliable communication by voice, observation, radio, or phone so workers can summon help quickly.
  • Where risk is significant, consider medical surveillance or heat-strain monitoring such as core temperature, hydration status, pulse, and blood pressure.
  • Reassess controls whenever weather, workload, PPE, staffing, or worker condition changes.

[4] [16] [4] [12] Worker exposure limits for heat are not a single universal OSHA PEL. Safe exposure depends on heat index or WBGT, humidity, radiant heat, air movement, workload, clothing/PPE, acclimatization, hydration, medications, and medical status. Because of that, employers should use a risk-based exposure assessment and set site-specific action levels for escalating controls, rest breaks, and medical response rather than relying on one temperature alone. [7] [3] [18]

  • Use engineering controls first where feasible: ventilation, fans, air conditioning, shade structures, reflective roofing, misting, and cooled cabs.
  • Use administrative controls next: work/rest schedules, task rotation, reduced pace, early/late shifts, and stop-work criteria for extreme risk.
  • Use personal cooling PPE when residual risk remains: cooling vests, wetted garments, supplied-air cooling systems, insulated or reflective clothing as appropriate.
  • Recognize that some PPE increases heat burden, especially respirators, impermeable clothing, and head coverings; adjust exposure time and breaks accordingly.

[13] [11] [11] [18]

  • Heat exhaustion signs commonly include heavy sweating, weakness or fatigue, dizziness or confusion, nausea, clammy skin, pale or flushed complexion, muscle cramps, and fast shallow breathing.
  • Heat stroke is a medical emergency; warning signs include high body temperature, confusion, dizziness, slurred speech, throbbing headache, chills, or hallucinations.
  • Any worker with altered mental status, collapse, persistent vomiting, or worsening symptoms should be treated as an emergency.

[1] [1] [15]

  • For suspected heat exhaustion: move the worker to a cool, shaded, or air-conditioned area; have them rest; give cool water or other non-alcoholic beverages if they are alert; and cool them with a shower, bath, or sponge bath.
  • For suspected heat stroke: call 911 immediately, notify supervision, move the worker to a cool shaded area, and begin aggressive cooling with water soaking, spraying/sponging/showering, and fanning.
  • Remove heavy outer clothing and PPE during cooling if this can be done safely.
  • Do not send a symptomatic worker back to duty until symptoms have resolved and they are medically cleared according to company procedure or applicable rule.

[1] [1] [15] A strong emergency response plan should define how to recognize heat illness, who to notify, how to contact emergency medical services, what transportation is available, who provides first aid, and how long EMS response will take. Employees should know the plan before work begins, and designated personnel should be equipped to call for medical help. Mock drills are a good practice for high-risk operations. [17] [4] [13]

In practice, a compliant and effective heat stress program should include: a designated program lead; documented hazard assessment; trigger levels for controls; water, rest, shade/cooling; acclimatization; worker and supervisor training; symptom monitoring and buddy checks; procedures for PPE-related heat burden; incident reporting and investigation; and emergency medical response. This combination aligns with current OSHA/state-plan enforcement expectations and recognized best practices for preventing heat illness. [3] [14] [15]

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Sources used for this answer

[1] Heat Stress - Hazard Alert

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# Heat Stress and Working in Hot Conditions (cont.) - Hallucinations * Chills - Throbbing headache - High body temperature - Confusion/dizziness - Slurred speech ## Take the following steps to treat a worker with heat stroke: - Call 911 and notify the worker's supervisor. - Move the sick worker to a cool shaded area. ✡ Cool the worker using methods such as: - Soaking the worker's clothes with water. - Spraying, sponging or showering the worker with water. - Fanning the worker's body. Heat exhaustion is the body's response to an excessive loss of the water and salt, usually through excessive sweating. Workers most prone to heat exhaustion are those who are elderly, those who have high blood pressure, and those working in a hot environment. ## Symptoms of heat exhaustion include: - Heavy sweating - Extreme weakness or fatigue - Dizziness, confusion * Nausea - Clammy, moist skin - Pale or flushed complexion - Muscle cramps - Slightly elevated body temperature - Fast and shallow breathing - Take the following steps to treat a worker with heat exhaustion: - Have the worker rest in a cool, shaded or air-conditioned area. - Have the worker drink plenty of water or other cool, non- alcoholic beverages. - Have the worker take a cool shower, bath or sponge bath. A good heat-related illness prevention program would likely contain the following elements; however, each work environment or situation may not require all elements. 1. Responsibilities of the employer and employees regarding working in hot, humid environments. 2. Environmental factors and personal health factors that contribute to heat-related illnesses. 3. Procedures for measuring air temperature and documenting effects of other environmental factors (humidity, wind strength, work location) by determining the wet bulb globe tem- perature (WBGT) index or heat index using any tool or resource available, including the OSHA Heat Safety Tool smart phone

[2] SC OSHA FACT SHEET: Protecting Workers from the Effects of Heat

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# Protecting Workers from the Effects of Heat (cont.) ## What is Heat Illness? (cont.) South Carolina OSHA Occupational Safety and Health Administration South Carolina Department of Labor, Licensing and Regulation Heat Rash is the most common problem in hot work environments. Heat rash is caused by sweating and looks like a red cluster of pimples or small blisters. Heat rash may appear on the neck, upper chest, groin, under the breasts and elbow creases. The best treatment for heat rash is to provide a cooler, less humid work environment. The rash area should be kept dry. Powder may be applied to increase comfort. Ointments and creams should not be used on a heat rash. Anything that makes the skin warm or moist may make the rash worse ## Occupational Factors that May Contribute to Heat Illness • High temperature and humidity • Low fluid consumption • Direct sun exposure (with no shade) or extreme heat • Limited air movement (no breeze or wind) • Physical exertion • Use of bulky protective clothing and equipment For more information, visit: https://osha.llr.sc.gov # PREVENTION MADE EASY ## Program Elements Heat Illness Prevention Program Key elements include: • A Person Designated to Oversee the Heat Illness Prevention Program • Hazard Identification • Water. Rest. Shade Message • Acclimatization • Modified Work Schedules • Training • Monitoring for Signs and Symptoms - Emergency Planning and Response ## Designate a Person to Oversee the Heat Stress Program Identify someone trained in the hazards, physiological responses to heat, and controls. This person can develop, implement and manage the program. ## Hazard Identification Hazard identification involves recognizing heat hazards and the risk of heat illness due to high temperature, humidity, sun and other thermal exposures, work demands, clothing or PPE and personal risk factors. Identification tools include: OSHA's Heat Smartphone App; a Wet Bulb Globe Thermometer (WBGT) which is a

[3] Heat Illness Prevention in Indoor Workplaces Fact Sheet for Employers

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# Heat Illness Prevention in Indoor Workplaces Information for Employers (cont.) ## Controls (cont.) • Require mandatory rest breaks in a cooler environment, such as a shady location or an air-conditioned building. The duration of the rest breaks should increase as heat stress rises. • Schedule work at cooler periods or times of day, such as early morning or late afternoon. . Rotate job functions among workers to help minimize exertion and heat exposure. If workers must be in proximity to heat sources, mark them clearly, so they are aware of the hazards. • Require employees to work in pairs or groups during extreme heat so they can monitor each other for signs of heat illness. Personal heat-protective equipment: If feasible engineering controls do not decrease the temperature enough and administrative controls do not minimize the risk of heat illness, special cooling devices that the employees wear can protect them in hot environments: • Water- or air-cooled garments, cooling vests, jackets, and neck wraps. The cooling source can be reusable ice packs or cooled air connected to an external source. • Supplied-air personal cooling systems. • Insulated suits. • Heat-reflective clothing. • Infrared reflecting face shields. Workers should be aware that the use of certain personal protective equipment for other hazards, such as respirators, impermeable clothing, and head coverings, can increase the risk of heat- related illness. ## Resources ## Cal/OSHA • Title 8, Section 3395, Heat Illness Prevention in Outdoor Places of Employment • Title 8, Section 3396, Heat Illness Prevention in Indoor Places of Employment • Publications - 0 Heat Illness • Cal/OSHA Heat Illness Prevention ## Fed OSHA • Overview: Working in Outdoor and Indoor Heat Environments • Prevention: Engineering Controls, Work Practices, and Personal Protective Equipment ## NIOSH • Heat Stress . Occupational Exposure to Heat and Hot Environments This document is available with activ

[4] MIOSHA Fact Sheet: Heat Stress

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# MIOSHA Fact Sheet # Heat Stress MIOSHA Michigan Occupational Safety and Health Administration # Before Heat Exposure Employers should create a Heat Illness Prevention Plan to protect workers from developing heat-related illnesses. The plan should include planning for acclimation, breaks, water, rest, shade, monitoring, training, and planning for heat emergencies. A sample plan can be found on the MIOSHA website: www.michigan.gov/leo/bureaus-agencies/miosha/topics/heat. Nearly 75% of heat fatalities occur in the first few days of working in warm or hot environments because the body needs to acclimate or build up a tolerance to heat gradually over time. When selecting workers for high heat jobs, remember that young people in generally good health, who are physically fit and have been exercising regularly in the heat, for at least the previous week or so, will be in the least discomfort and danger. People who are not in good physical condition, and who have not acclimated to the heat, as well as infants and the aged, will be in the greatest danger and discomfort during heat stress. Instruct everyone who is to be heat exposed and those responsible for the activities, how to prevent heat- related illness as well as how to recognize the early warning signs and symptoms of heat stress. Also train workers to reduce discomfort and the dangers of early stages of heat exposure. ## During Heat Exposure Do: 1. Allow new or returning workers to gradually increase workloads and take more frequent breaks as they acclimate, or build tolerance, for working in the heat. • For new workers, the schedule should be no more than a 20% heat exposure on day one and an increase of no more than 20% on each additional day. • For workers who have previous experience with the job, the acclimation regimen should be no more than a 50% heat exposure on day one, 60% on day two, 80% on day three, and 100% on day four. 2. If working or exercising OUTDOORS, wear loose fitting, light

[5] Heat Stress Pamphlet

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# Virginia Department of Labor and Industry (cont.) ## Working in Hot Environments Fifty to seventy percent of work related injuries happen within the first few days of working in warm or hot environments. Our bodies need time to acclimate to the heat. If workers start a job without properly acclimating to the heat, they are at major risk for fatal outcomes. ## Heat Illness Program Elements: Designate someone to oversee the Heat Illness Prevention Program Identify Heat Hazards Water, Rest, Shade Acclimatization Modify Work Schedules Training of Employees Monitoring employees for signs of Heat Illness Emergency Response Planning We are here to help! ## First Aid If any symptoms of heat illness are present the following actions should be taken: • Get worker to cool shaded area • Immerse the worker in cold water/ice bath . Remove heavy layers of clothing and PPE - Place ice or cold wet towels on the head, neck, trunk, armpits, or groin - Use fans to circulate the air around the worker - Give Water - Let Rest • If employee does not improve call 911 # Signs of Heat Illness - Confusion - Dizziness • Fainting • Fatigue • Headache • High body temperature • Muscle or abdominal cramps - Nausea, vomiting, or diarrhea • Pale skin • Profuse sweating - Rapid heartbeat HEAT STROKE SYMPTOMS OF HEAT STROKE " PREVENTION Who is at risk of heat-related illness?

[6] Key requirements: Oregon OSHA’s permanent rules for heat illness prevention

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# KEY REQUIREMENTS: OREGON OSHA'S PERMANENT RULES FOR HEAT ILLNESS PREVENTION • The environmental and personal risk factors for heat illness, including the extra burden of heat caused by exertion, clothing, and personal protective equipment. • The procedures for complying with the requirements of this standard, including the employer's responsibility to provide water, daily heat index information, shade, cool-down rests, how to report symptoms of heat-related illness, and access to first aid, as well as the employees' right to exercise their rights under this standard without fear of retaliation. • How to adapt to working in a hot environment. • The importance of employees immediately reporting symptoms or signs of heat illness - in co-workers or themselves. • The effects of nonjob factors - such as medications, alcohol, and obesity - on tolerance to heat stress. • The main types of heat-related illnesses - heat cramps, heat exhaustion, heat syncope, and heat stroke and their signs and symptoms. • The importance of frequent consumption of small quantities of water, up to 32 ounces per hour. Those performing "rest" or light" work, as defined by the rules, are exempt from the training requirements when the heat index is less than 90 degrees Fahrenheit. ## High heat practices When the heat index exceeds 90 degrees Fahrenheit, employers must implement the following additional high heat practices: • Ensure that effective communication by voice, observation, or electronic means is maintained so that employees working at the site can contact a supervisor when necessary. Cellphones and text messaging may be used for this purpose only if reception in the area is reliable. • Ensure that employees are monitored for signs of heat illness, and whether medical attention is necessary, using one or more of the following: - Regular communication with employees working alone - by radio, cellphone, or other alternative means. - A mandatory buddy system. - Other eq

[7] Heat Illness Prevention in Indoor Workplaces Fact Sheet for Employers

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# Heat Illness Prevention in Indoor Workplaces Information for Employers (cont.) ## What must employers do? Access to clean drinking water: Employers are required to provide access to potable water that is fresh, suitably cool, and free of charge. It must be located as close as practicable to the work area and cooling area. If an employer does not provide plumbed water, they are required to provide at least one quart per hour per employee per shift. Employers must encourage frequent water consumption. Cool-down areas and rest periods: Employers must provide access to at least one cool-down area which must be maintained at a temperature below 82°F, blocked from direct sunlight, shielded from other high-radiant heat sources, large enough to accommodate the number of employees on rest breaks, and as close as practicable to the work area. They must allow employees who ask for a cool-down rest period to take one. In addition, employers must encourage employees to take preventative cool-down rest periods and monitor employees taking such rest periods for symptoms of heat-related illness. If symptoms persist, they may not be ordered back to work. Assessing and measuring heat: Employers must measure the temperature and heat index and record whichever is greater whenever the temperature or heat index reaches 87°F (or temperature reaches 82°F for employees working in clothing that restricts heat removal or high radiant heat areas). This is an important step to ensure that employers know when to implement control measures to keep employees safe. Emergency response procedures: Employers must provide first aid or emergency response to any workers showing heat illness signs or symptoms, including contacting emergency medical services. Acclimatization: Employers must closely observe new employees and newly assigned employees working in hot areas during a 14-day acclimatization period, as well as all employees working during a heat wave where no effective engineering controls

[8] SC OSHA FACT SHEET: Protecting Workers from the Effects of Heat

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# PREVENTION MADE EASY (cont.) ## Hazard Identification (cont.) South Carolina OSHA Occupational Safety and Health Administration South Carolina Department of Labor, Licensing and Regulation ## Water. Rest. Shade Ensure that cool drinking water is available and easily accessible. (Note: Certain beverages, such as caffeine and alcohol can lead to dehydration.) Encourage workers to drink a liter of water over one hour, which is about one cup every fifteen minutes. Provide or ensure that fully shaded or air- conditioned areas are available for resting and cooling down. ## Acclimatization Acclimatization is a physical change that allows the body to build a tolerance to working in the heat. It occurs by gradually increasing workloads and exposure and taking frequent breaks for water and rest in the shade. Full acclimatization may take up to 14 days or longer depending on factors relating to the individual, such as increased risk of heat illness due to certain medications or medical conditions, or the environment. New workers and those returning from a prolonged absence should begin with 20% of the workload on the first day, increasing incrementally by no more than 20% each subsequent day. During a rapid change leading to excessively hot weather or conditions such as a heatwave, even experienced workers should begin on the first day of work in excessive heat with 50% of the normal workload and time spent in the hot environment, 60% on the second day, 80% on day three, and 100% on the fourth day For more information, visit: https://osha.llr.sc.gov # Modified Work Schedules Altering work schedules may reduce workers' exposure to heat. For instance: - Reschedule all non-essential outdoor work for days with a reduced heat index. • Schedule the more physically demanding work during the cooler times of day; • Schedule less physically demanding work during warmer times of the day; • Rotate workers and split shifts, and/or add extra workers. • Work/Rest cycles,

[9] Frequently Asked Questions (FAQs): Heat Illness Prevention

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# Section (2) Exemptions (cont.) ## What are the required elements for an Oregon OSHA Emergency Medical Plan? (cont.) FREQUENTLY ASKED QUESTIONS (FAQS): HEAT ILLNESS PREVENTION have, in addition to the information required in 437- 002-0161(4)(a), a definite plan of action to be followed in the event of serious injury to an employee. The plan of action shall consist of the arrangements for: (A) Communication - two-way radio telephone, or provision for emergency communication to contact the emergency medical services. (B) Transportation - availability of transportation to a point where an ambulance can be met or to the nearest suitable medical facility. Vehicles provided for this purpose shall be available at all times, shall have right-of-way over all vehicles or equipment under the control of the employer, and shall be equipped so that due consideration can be given to the proper care and comfort of the injured employee. (C) Qualified medical personnel at destination. (D) All employees shall be knowledgeable concerning the qualified first aid person(s), the first aid requirements, and emergency medical plan. ## Do you have a sample emergency medical plan? Sample plans are available online but they need to be tailored to the business operations and locations where employees are working. It's important to note: The emergency medical plan was required for some employers prior to the heat illness rules. ## Resources: • Federal OSHA - How to plan for workplace emergencies and evacuations • Oregon OSHA - Expecting the Unexpected ## Section (7) Acclimatization Plan What are some good resources to learn more about acclimatization? • CDC NIOSH Heat Stress Acclimatization Plan • CDC Acclimatizing Workers Oregon OSHA's Local Emphasis Program - Preventing Heat-Related Illness ## What are the definitions of "acclimated" and "unacclimated"? Acclimated means that employees are used to working in high-temperature environments, and unacclimated means that employee

[10] Frequently Asked Questions (FAQs): Heat Illness Prevention

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# Section (2) Exemptions (cont.) ## Section (8) Heat Illness Prevention Plan (cont.) FREQUENTLY ASKED QUESTIONS (FAQS): HEAT ILLNESS PREVENTION ## Section (9) Supervisor and employee training What topics must all employees, whether supervisors or non-supervisory, be trained on annually to prevent heat-related illness? Prior to being exposed to high heat, all employees must be trained in: • The environmental and personal risk factors (for example, chronic obstructive pulmonary disease, asthma, kidney disease, obesity, etc.) for heat illness that may limit an individual's tolerance to excessive heat, as well as the added burden of heat load on the body caused by exertion, clothing (refer to Section 5 in Appendix A, Information for Heat Illness Prevention), and personal protective equipment. • The employer's procedures for complying with the requirements of this standard, including, but not limited to, the employer's responsibility to provide water, heat index information (including the risks to experiencing a heat-related illness), shade, preventative rest breaks, and access to first aid, as well as how employees can exercise their rights under this standard without fear of retaliation. • The importance of frequent consumption of small quantities of water, up to 32 ounces 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 concept, importance, and methods of the acclimatization plan pursuant to the employer's procedures under section (8). - The different types of heat illness, the common signs and symptoms of heat illness, and the appropriate first aid and emergency response to the different types of heat illness, including how heat illness may progress quickly from mild signs and symptoms to a serious and life-threatening condition. • The importance for employees to immediately report to the employer, directly or through the employee's supervisor, signs and symptom

[11] Frequently Asked Questions (FAQs): Heat Illness Prevention

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# Section (2) Exemptions (cont.) ## Heat Illness Prevention Plan: (cont.) FREQUENTLY ASKED QUESTIONS (FAQS): HEAT ILLNESS PREVENTION (8)(b) How to recognize the symptoms of dehydration, and how to respond to suspected heat-related illnesses in others; (8)(e) How employees will be provided sufficient space to rest in a shaded area or cool climate-controlled area, and where heat-affected employees may cool off and recover when signs and symptoms of heat-related illnesses are recognized; ## Supervisor and employee training: (9)(b) The employer's procedures for complying with the requirements of this standard, including, but not limited to, the employer's responsibility to provide water, heat index information (including the risks to experiencing a heat-related illness), shade, preventative rest breaks, and access to first aid, as well as how employees can exercise their rights under this standard without fear of retaliation; (9)(f) The importance for employees to immediately report to the employer, directly or through the employee's supervisor, signs and symptoms of heat illness in themselves or in others. Does Oregon OSHA have the authority to classify a rest break as a "work assignment"? Yes, Oregon OSHA has the regulatory authority to classify rest breaks as "work assignments." Our employees work by 'piece rate' and they do not want to take additional rest breaks when the heat index is equal to or greater than 90 degrees Fahrenheit; what are our options? Employers are required to provide heat illness prevention rest breaks for employees who work by "piece rate." Can we use one heat illness prevention rest break for a group of our employees and another one for another group of our employees? Yes, employers may use one option for a group of employees and another option for another group of employees, as long as employees don't switch between groups. For the Simplified Work/Rest Schedule, does 10 minutes every two hours mean 110 minutes of work and 10 min

[12] Protect Your Workers From Heat Stress

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PROTECT YOUR WORKERS FROM HEAT STRESS ## Develop an acclimatization plan Acclimatization is the result of beneficial physiological adaptations (e.g., increased sweating efficiency and stabilization of the circulation) that occur after gradual increased exposure to a hot environment. TIP 1 TIP 2 Gradually increase the time spent in hot environmental conditions over a 7-14 day period. For new workers, the schedule should be no more than 20% exposure to heat on day 1 and an increase of no more than 20% exposure on each additional day. ## TIP 3 ✓ they don't have heat-related symptoms. For workers who have had previous experience with the job, the acclimatization schedule should be no more than: <table><tr><th>DAY 1</th><th>DAY 2</th><th>DAY 3</th><th>DAY 4</th></tr><tr><td>50%</td><td>60%</td><td>80%</td><td>100%</td></tr><tr><td>EXPOSURE</td><td>EXPOSURE</td><td>EXPOSURE</td><td>EXPOSURE</td></tr></table> ## Set up a buddy system Check your workers routinely to make sure... - they make use of readily available water and shade. ## Schedule and encourage frequent rest breaks... ...with water breaks in shaded or air-conditioned recovery areas. ## Emphasize the need for appropriate clothing Encourage workers to wear clothing that is... light-colored breathable - loose-fitting ## Encourage workers to drink plenty of fluids... ...such as drinking small amounts of water before becoming thirsty. Cotton clothing can be soaked in water to aid cooling. Be aware that protective clothing or personal protective equipment may increase the risk of heat stress. mm During moderate activity in moderately hot conditions, workers should drink about... 1 cup every 15 to 20 minutes. Learn more about heat stress at: www.cdc.gov/niosh/topics/heatstress DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health CDC Workplace Safety and Heath NIOSH

[13] Heat Stress

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DEPARTMENT US VIRGIN ISLANDS 8" of LABOR VIDOSH 70% -100° 60% 95 50% 90 40% 85" 30% 80 Lidity mpora # Heat Stress §1910.120(g)(5)(x) Wearing PPE puts any worker at considerable risk of developing heat stress. This can result in health effects ranging from transient heat fatigue to serious illness or death. Heat stress is caused by a number of interacting factors, including environmental conditions, clothing, workload, and the individual characteristics of the worker. Because heat stress is probably one of the most common (and potentially serious) illnesses at hazardous waste sites, regular monitoring and other preventive precautions are vital. Individuals vary in their susceptibility to heat stress. Factors that may predispose someone to heat stress include: . Lack of physical fitness. • Lack of acclimatization. • Age. - Dehydration. • Obesity. • Alcohol and drug use. • Infection. • Sunburn. • Diarrhea. • Chronic disease. MY II AI Reduced work tolerance and the increased risk of excessive heat stress is directly influenced by the amount and type of PPE worn. PPE adds weight and bulk, severely reduces the body's access to normal heat exchange mechanisms (evaporation, convection, and radiation), and increases energy expenditure. Therefore, when selecting PPE, each item's benefit should be carefully evaluated in relation to its potential for increasing the risk of heat stress. Once PPE is selected, the safe duration of work/rest periods should be determined based on the: • Anticipated work rate. • Ambient temperature and other environmental factors. • Type of protective ensemble. - Individual worker characteristics and fitness.

[14] OSH Enforcement Procedures | OPN 141 - Enforcement Guidance for Conducting Heat-Related Illness Inspections and Issuing Citations

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# Raleigh, NC (cont.) ## Training: (cont.) OPN 141B cont'd. # Appendix C - Example SAVES and AVDs Example 1 North Carolina General Statute §95-129(1) of the Occupational Safety and Health Act of North Carolina: The employer did not furnish each of his employees conditions of employment and a place of employment free from recognized hazards that were causing or likely to cause death or serious physical harm to employees in that employees were exposed to heat-related hazards associated with working in a hot environment: a) On or about and at times prior to [the date of the incident], employees were exposed to conditions of high ambient heat from [list sources of ambient heat] during the performance of their job duties, including [describe task]. [Describe temperature, relative humidity, clothing, and level of workload. Include any NOAA heat advisory or alert that supports a hazardous heat condition]. Such exposures may lead to the development of serious heat-related illnesses such as, but not limited to, heat cramps, heat exhaustion, and heat stroke [describe any heat-related incidents/illnesses that occurred]. One feasible and acceptable abatement method, among others, to correct this hazard is to develop a heat stress prevention program to include elements such as the following: 1) The development of a heat stress training program to inform employer and employees about the effects of heat stress and how to recognize heat-related symptoms and prevent heat-related illnesses. 2) The utilization of an acclimatization program for new employees when they begin working or return to work in hot environments. 3) The monitoring of weather conditions and establishment of work schedules and break periods to minimize heat exposure. 4) Providing shaded areas and/or other cool areas for breaks. 5) Implementation of a screening program to determine any causal factors that may affect the employee's heat illness susceptibility. 6) Ensuring an adequate supply of drinking

[15] TOGETHER WITH TOSHA newsletter: Chainsaw Safety

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# 12 Elements of a Heat Illness Prevention Program (cont.) ## 6. Allow Frequent Rest Breaks (cont.) OSHA continued from page 5 Occupational Safety and Health Administration Heat Illness Prevention # Set Controls and Monitor On-Site Activity ## 7. Identify Heat Hazards Hazard identification is recognizing heat hazards and the risk of heat illness due to high temperature, humidity, sun and other thermal exposures, work demands, clothing or PPE, and personal risk factors. Use this checklist to identify potential sources of heat hazards. ## 8. Check the Temperature in the Space Before Work Use apps and tools to track heat hazards. - For outdoor work, use the OSHA-NIOSH Heat Safety Tool App (Apple Store or Google Play) to plan activities based on how hot it feels throughout the day. Consult the National Weather Service Heat Index and watch for high temperature weather alerts. - For indoor work, use a combination thermometer and hygrometer to identify the heat index in the work area. Post signage of actions to take based on the work area's heat index. | ៦៦២ PTTOR ## 9. Monitor for Heat Illness Symptoms Establish a monitoring system for the signs and symptoms of heat illness. Also train workers to monitor each other. A buddy system can help supervisors watch for signs of heat illness. More robust heat illness prevention programs establish a medical monitoring program. This should include medical evaluations before a worker starts (pre-placement) and periodic medical evaluations. The program should also include a plan for monitoring worker heat strain (e.g., core temperature, hydration, pulse, and/or blood pressure) on the job. ## 10. Designate a Break Area and Encourage Hydration Remember: Water, Rest, Shade. Designate a shady or cool area for breaks and provide cool drinking water. Portable tents and shelters can be a solution for areas without natural shade. Ensure drinking water is available and accessible and encourage workers to drink 1 liter pe

[16] TOGETHER WITH TOSHA newsletter: Employers Must Be Proactive to Prevent Heat Illness

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# Employers Must Be Proactive to Prevent Heat Illness continued from page 2 ## Work-Rest Cycles Adjust work schedules to include frequent breaks in shaded or air-conditioned areas, especially during the hottest parts of the day. Use rotating shifts to reduce individual heat exposure. ## Engineering Controls Introduce ventilation systems, shade structures, cooling fans, or misting systems. In indoor settings, improve air conditioning or use reflective roofing materials to lower heat accumulation. ## Administrative Controls Implement policies that reduce heat exposure, such as limiting overtime in extreme heat, educating workers about symptoms, and training supervisors to monitor signs of heat stress. Some employers may wish to change work hours or develop a stop work temperature as well. ## Personal Protective Equipment (PPE) Where possible, provide cooling vests, breathable clothing, or heat-reflective garments. Modify protective clothing to reduce heat burden without compromising safety. ## Emergency Response Planning Ensure prompt access to medical services. Train workers and supervisors in first aid for heat-related conditions and establish clear procedures for emergencies. Perform mock emergency response events for heat illness events. ## Conclusion Preventing occupational heat illness is a health priority and a legal responsibility. Employers must take proactive steps to mitigate heat risks, safeguard worker health, and maintain productivity. Through training, environmental adjustments, and workplace policies, most heat- related illnesses can be effectively prevented. O 3 TOGETHER WITH TOSHA

[17] MNOSHA Directive | Enforcement Guidelines for Outdoor Exposure to Heat Stress

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# Heat Index Chart (cont.) MNOSHA Instruction STD 1-4.2A March 1, 2021 # Appendix B # HEAT-RELATED INSPECTION QUESTIONNAIRE ## General • - Are there any recorded heat-related incidents on the OSHA 300 log? - о If yes, please list. • Is the work being done in the direct sun or a facility that is not air conditioned (e.g., warehouse)? . What are the potential sources of heat? . Is the heat stress potential regularly evaluated/monitored? - о If yes, please describe how (e.g., buddy system) • How long have employees worked at this task or work assignment? • Are employees required to wear protective clothing or equipment? ○ If yes, please describe. - о Are there additional requirements for employees working in PPE (e.g., impervious clothing)? • - What actions were implemented to prevent heat-related illnesses? • Is there a heat stress prevention program in place? - Has the employer taken steps to reschedule strenuous tasks for cooler parts of the day or days with reduced temperatures? - о Has the employer bought equipment with air-conditioned cabs? • Is there an acclimatization program? - о Are the employees acclimatized to the work environment? ## Water • Is drinking water available? - If yes, describe drinking water source and proximity to workers. • Are workers required to drink water or any other beverages when working under hot conditions? ○ - If yes, is there a specific amount to ensure employees are drinking enough water? ○ Is it enforced? - Are water coolers refilled throughout the day? ## Rest • Is there a Work/Rest Cycle in Place? - о If yes, describe the work/rest cycle (e.g., how many breaks do you take, when/where do you take breaks, how long is a typical break, etc.) - о Is there a knowledgeable person on site who is authorized to modify work tasks and work/rest schedules as necessary? Page 6 of 9

[18] Oregon OSHA Program Directive | Local Emphasis Program (LEP): Preventing Heat-Related Illness and guidance on Heat Illness Prevention rules [redacted phone] and 437-004- 1131

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# Appendix C (cont.) ## SAMPLE HAZARD LETTER (cont.) (A) The shade area must either be open to the air or provide mechanical ventilation for cooling. (B) The amount of shade present must 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. (C) The shade must be located as close as practical to the areas where employees are working. (D) Shade present during meal periods must be large enough to accommodate the number of employees on the meal period that remain onsite. (b) When the employer can demonstrate that providing access to shade is not safe or feasible in a particular situation (for example, during high winds or when an employee is walking through range land), employers must identify and implement alternative cooling measures that provide equivalent protection. 2. Drinking water. Employers whose work activities are covered by this rule must ensure that an adequate supply of additional drinking water is readily accessible to employees at all times and at no cost when the heat index in the work area equals or exceeds 80° F. (a) Employers must supply each employee enough water to enable them to consume 32 ounces per hour. (b) Employers are not required to supply the entire quantity of drinking water needed for all employees on a full shift at the beginning of the shift. Employers may begin the shift with smaller quantities of drinking water if effective procedures are established to replenish the water consumed during the shift. (c) Employers must ensure that employees have ample opportunity to drink water supplied. 3. Supervisor and employee training. The employer must ensure that all employees, including new employees, supervisory, and nonsupervisory employees, are trained in the following topics, in a language readily understood, before employees begin work that can reasonably be anticipated to expose employees to a heat index equal to or in exc

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