Toolbox talk regarding heat stress

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# HEAT EXHAUSTION Last Review: 08/01/2025 Date Posted: 09/09/2016 Working in the heat and doing heavy physical work can affect the body's cooling system. If your body is unable to cool itself, you can experience heat stress. If heat stress is not treated, it can develop into heat stroke, which can result in death. Heat Exposure applies to outdoor work environments from May 1 through September 30, when employees are exposed to outdoor heat at or above an applicable temperature listed in Table 1. WAC 296-62-[redacted postal code]. Remember, heat exposure can happen anytime of the year, as well as indoors. ## SIGNS AND SYMPTOMS • Shallow breathing • Increased breathing rate • Weak, rapid pulse • Cool, pale, clammy skin • Sweating • Weakness, fatigue, dizziness • Headache and nausea - Fainting • Muscle cramps ## TREATMENT • Move the worker to a cooler environment. If possible, lay the worker down, and remove or loosen tight-fitting clothing. • Cool the worker by sponging with cool water and fanning. Take care not to cool the worker too much. If the worker begins to shiver, stop cooling. - In most cases, the patient's symptoms will improve dramatically within 30 minutes. - Call 911 immediately if there are signs of Heat Stroke (confusion, agitation, absence of sweating or loss of consciousness). ## PREVENTION • - Acclimatize your body (gradually expose yourself to warmer work environments). • Drink plenty of water (one glass every 20 minutes). • Wear clean, light-colored, loose-fitting clothing made of breathable fabric. • Take rest breaks in a cool or well-ventilated area. • Take more breaks during the hottest part of the day or when doing hard physical work. Allow your body to cool down before beginning again. • Take care not to burn. This can occur in as little as 10 minutes • If desired, apply high factor sun-screen generously and frequently to any parts of the body exposed to the sun; SPF15 or above • Remember to - hydrate before yo…

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# Water, Rest, Shade The three biggest things for employers to remember is to provide water, rest, and shade. • Employers should provide cool water for workers to drink. Proper hydration is key in preventing heat illness. It is also a good idea to provide drinks with electrolytes, because electrolytes are lost when we sweat. • When heat stress is high, employers should require workers to take breaks. The length and frequency of rest breaks should increase as heat stress rises. - Workers should be given a cool location where they can take their breaks and recover from the heat. • Outdoors, this might mean a shady area, an air-conditioned vehicle, a nearby building or tent, or an area with fans and misting devices. • Indoors, workers should be allowed to rest in a cool or air-conditioned area away from heat sources such as ovens and furnaces. VIRGINIA DEPARTMENT OF LABOR AND INDUSTRY

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# SIGNS & SYMPTOMS OF HEAT-RELATED ILLNESS <table><tr><th>Heat-Related Illness</th><th>Symptoms and Signs</th></tr><tr><td></td><td>• Confusion</td></tr><tr><td></td><td>• Slurred speech</td></tr><tr><td></td><td>• Unconsciousness</td></tr><tr><td>Heat stroke</td><td>• Seizures</td></tr><tr><td></td><td>• Heavy sweating or hot, dry skin</td></tr><tr><td></td><td>• Very high body temperature</td></tr><tr><td></td><td>• Rapid heart rate</td></tr><tr><td></td><td>• Fatigue</td></tr><tr><td></td><td>• Irritability</td></tr><tr><td></td><td> Thirst</td></tr><tr><td>Heat exhaustion</td><td>• Nausea or vomiting</td></tr><tr><td></td><td> Dizziness or lightheadedness</td></tr><tr><td></td><td>• Heavy sweating</td></tr><tr><td></td><td>• Elevated body temperature or fast heart rate</td></tr><tr><td></td><td> Muscle spasms or pain</td></tr><tr><td>Heat cramps</td><td>• Usually in legs, arms, or trunk</td></tr><tr><td></td><td> Fainting</td></tr><tr><td>Heat syncope</td><td> Dizziness</td></tr><tr><td></td><td>• Clusters of red bumps on the skin</td></tr><tr><td>Heat rash</td><td> Often appears on the neck, upper chest, and skin folds</td></tr><tr><td></td><td>• Muscle pain</td></tr><tr><td>Rhabdomyolysis (muscle breakdown)</td><td>• Dark urine or reduced urine output • Weakness</td></tr></table> ## HEAT STRESS CONTROLS Engineering Controls - The best way to prevent heat-related illness for indoor workers is to make the work environment cooler. Wherever possible, use air conditioning to cool the work area. Alternatively, increase the general ventilation as much as possible by opening windows or doors. When available, use cooling fans to aid in increasing ventilation. Safe Work Practices - Employees working outdoors or indoors without air conditioning or ventilation take scheduled breaks in cool and shaded areas. Ensure plenty of cool water to drink, and take water breaks as needed. Immediately report any problems to a supervisor. Supervisors should consider scheduling the …

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# HEAT-RELATED HAZARDS & CONTROLS Date Posted: 02/17/2024 Workers exposed to extreme heat or working in hot environments may be at risk of heat stress. Exposure to extreme heat can result in occupational illnesses and injuries. For example, heat stress can result in heat-related illnesses such as heat stroke, heat exhaustion, heat cramps, or heat rashes. Heat can also increase the risk of traumatic injuries as it may result in poor grip, fogged-up safety glasses, and problems with balance. According to the Bureau of Labor Statistics (BLS), high temperatures can be dangerous to people at work and can lead to injuries, illnesses, and even death. Exposure to environmental heat led to 37 work-related deaths and 2,830 nonfatal occupational injuries and illnesses involving days away from work in 2020. Thirty-three of the 37 fatal work injuries caused by exposure to environmental heat occurred in the summer months of June through September. On June 27, 2023, the Washington State Department of Labor & Industries (L&I) adopted updates to Outdoor Heat Exposure rules to prevent heat- related illness and reduce traumatic injuries associated with heat exposure. The adopted rules include requirements for shade, rest, and acclimatization and lowers the temperatures at which some preventive actions must be taken. ## WASHINGTON STATE ACTION LEVELS Clothing/PPE Worn Action Level Temperature Nonbreathing clothing, including vapor-barrier clothing or chemical-resistant suits 52° All other clothing 80° ## THE IMPORTANCE OF ACCLIMATIZATION Workers are at higher risk of heat-related illness if they are not acclimatized or used to the heat. Acclimatization typically takes 7-14 days to develop and can be lost after seven days away from working in the heat. A sudden increase in temperature does not allow time for workers to acclimate. Acclimatization is a process by which the physical processes of a worker's body adjust to the environment over some time. Based on data obtained from…

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# HEAT-RELATED INSPECTION QUESTIONNAIRE (cont.) ## Rest (cont.) MNOSHA Instruction STD 1-4.2A March 1, 2021 ## Shade • Is shade or a climate-controlled area available for breaks, rest periods and if workers need to recover? о If yes, please describe. ## Health Effects / Emergencies • Have employees experienced any health effects (e.g., dizziness, nausea, not sweating) related to working in excessive heat? - If yes, describe. • What is done if employees suffer heat-related health effects? • Does everyone know who to notify if there is an emergency? • Does everyone know who will provide first aid? ## Training • Have employees received training on the effects of heat and heat-related illnesses? - о If yes, what information was provided? о - Are OSHA or other materials on heat-related illness posted in the workplace? - Do workers know the: - о Common signs and symptoms of heat illness? ○ Proper precautions to prevent heat illness? (are the precautions updates as necessary) ○ O Importance of acclimatization? O - Importance of drinking water frequently (even when they are not thirsty)? - O о о Steps to take if someone is having symptoms? Page 7 of 9

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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…

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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…

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## Recognize the signs of heat illnesses in yourself and your co-workers: (cont.) CPWR TOOLBOX RESEARCH AND TRAINING THE CENTER FOR CONSTRUCTION TALK Hot Environments × Recognize the signs of heat-related illnesses. Call 911 if a co-worker has signs of heat exhaustion or heat stroke. Move the worker to the shade, help them cool down, and encourage them to drink water or a sports drink. - Drink 1 cup (8 ounces) of water every 15-20 minutes. * Take frequent breaks out of the sun. ©2017, CPWR-The Center for Construction Research and Training. All rights reserved. CPWR is the research and training arm of NABTU. Production of this document was supported by cooperative agreement OH 009762 from the National Institute for Occupational Safety and Health (NIOSH). The contents are solely the responsibility of the authors and do not necessarily represent the official views of NIOSH. CPWR 【● THE CENTER FOR CONSTRUCTION RESEARCH AND TRAINING

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OSHACK CARD™ # Protect Yourself Heat Stress When the body is unable to cool itself by sweating, several heat-induced illnesses such as heat stress or heat exhaustion and the more severe heat stroke can occur, and can result in death. ## Factors Leading to Heat Stress High temperature and humidity; direct sun or heat; limited air movement; physical exertion; poor physical condition; some medicines; and inadequate tolerance for hot workplaces. ## Symptoms of Heat Exhaustion • Headaches, dizziness, lightheadedness or fainting. • Weakness and moist skin. • Mood changes such as irritability or confusion. - Upset stomach or vomiting. ## Symptoms of Heat Stroke • Dry, hot skin with no sweating. - Mental confusion or losing consciousness. • Seizures or convulsions. ## Preventing Heat Stress - Know signs/symptoms of heat-related illnesses; monitor yourself and coworkers. - Block out direct sun or other heat sources. • Use cooling fans/air-conditioning; rest regularly. - Drink lots of water; about 1 cup every 15 minutes. • Wear lightweight, light colored, loose-fitting clothes. • Avoid alcohol, caffeinated drinks, or heavy meals. ## What to Do for Heat-Related Illness Call 911 (or local emergency number) at once. - While waiting for help to arrive: • Move the worker to a cool, shaded area. • Loosen or remove heavy clothing. • Provide cool drinking water. • Fan and mist the person with water. For more complete information: Occupational OSHA Safety and Health Administration U.S. Department of Labor www.osha.gov (800) 321-OSHA OSHA 3154-07R-06

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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

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# OSHA NIOSH INFOSHEET ## Protecting Workers from Heat Illness At times, workers may be required to work in hot environments for long periods. When the human body is unable to maintain a normal temperature, heat-related illnesses can occur and may result in death. This fact sheet provides information to employers on measures they should take to prevent heat-related illnesses and death. ## Factors That Increase Risk to Workers • High temperature and humidity • Direct sun exposure (with no shade) • Indoor exposure to other sources of radiant heat (ovens, furnaces) • Limited air movement (no breeze) • Low fluid consumption • Physical exertion . Heavy personal protective clothing and equipment • Poor physical condition or health problems • Some medications, for example, different kinds of blood pressure pills or antihistamines • Pregnancy • Lack of recent exposure to hot working conditions • Previous heat-related illness • Advanced age (65+) ## Health Problems Caused by Hot Environments Heat Stroke is the most serious heat-related health problem. Heat stroke occurs when the body's temperature regulating system fails and body temperature rises to critical levels. Heat stroke is a medical emergency that may rapidly result in death! Symptoms of heat stroke include: • Confusion • Loss of consciousness • Seizures • Very high body temperature • Hot, dry skin or profuse sweating If a worker shows signs of possible heat stroke: • Heat stroke is a life-threatening emergency! While first aid measures are being implemented, call 911 and get emergency medical help. • Make sure that someone stays with the worker until help arrives. • Move the worker to a shaded, cool area and remove outer clothing. • Wet the worker with cool water and circulate the air to speed cooling. • Place cold wet cloths or ice all over the body or soak the worker's clothing with cold water. Heat Exhaustion is the next most serious heat- related health problem. Symptoms …

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WORKER HEALTH AND SAFETY # HEAT EXHAUSTION ## SYMPTOMS MAY INCLUDE: Headaches, dizziness, light-headedness, weakness, personality changes, irritability or confusion, feeling sick to your stomach, vomiting, fainting, decreased and dark- colored urine, and pale, clammy skin. ## WHAT SHOULD BE DONE: • Move them to a cool, shaded area. Don't leave them alone. If they are dizzy or light-headed, lay them on their back and raise their legs about 6-8 inches. If they are sick to their stomach, lay them on their side. • Loosen and remove heavy clothing. - Have them drink some cool water (a small cup every 15 minutes) if they are sick to their stomach. • Try to cool them by fanning. Cool their skin with a cool spray mist of water or wet cloth. • If their condition worsens, call 911 for emergency help. If heat exhaustion is not treated, the illness may advance to heat stroke. OSHA Oregon OSHA Department of Consumer and Business Services 440-3333E-S (06/22/COM) # HEAT STROKE-A Medical Emergency ## SYMPTOMS MAY INCLUDE: Dry, pale skin (no sweating); hot, red skin (looks like a sunburn); personality changes; irritability, confusion, and not making any sense; seizures or fits, and collapse (will not respond). ## WHAT SHOULD BE DONE: • Call 911 for emergency help. • Move those suffering to a cool, shaded area. Don't leave them alone. Lay them on their back and if they are having seizures, remove close objects for safety. If they are sick to their stomach, lay them on their side. - Remove heavy and outer clothing. - Have them drink some cool water (a small cup every 15 minutes) if they are alert and not feeling sick to their stomach. • Try to cool them by fanning. Cool the skin with a cool spray mist of water, wet cloth, or wet sheet. • If ice is available, place ice packs in armpits and groin area. Heat Stress App and Oregon OSHA Permanent Heat Rules (effective June 2022): osha.oregon.gov, A to Z topic index, Heat Stress ## Heat Stress Table Be aware of…

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# HEAT STRESS ## Date Posted: 09/08/2016 Washington State can be known for its extreme temperatures. The temperature can change 20 degrees from one day to the next. Excessive heat can contribute to accidents in many ways. It becomes more difficult to concentrate on the job and this can lead to errors in judgment. It is important to be aware of the danger signs. When wearing restrictive clothing, even lower temperature can be dangerous. ## HEAT EXHAUSTION SYMPTOMS • Person is dazed, staggers, or becomes dizzy. • Person may present symptoms of nausea or vomiting and the person can feel chilly. • Person's face looks pale. • Person has weak pulse and body temperature is below normal. • Person is heavily sweating with clammy/moist skin. ## HEAT EXHAUSTION PREVENTION • Avoid ice water while working - Drink plenty of liquids, preferably water, every 15 minutes, even if you are not thirsty • Avoid heavy, fatty-type foods • Wear light colored clothing • Avoid fatigue; get plenty of rest REMEMBER: Alcohol consumption off work hours can still contribute to dehydration the next day. ## WHAT TO DO • Move person to a cooler place. Do not leave alone. • Loosen and remove heavy clothing that restricts evaporative cooling . If conscious, provide small amounts of cool water to drink • Remember three simple words: water, rest, shade. ## HEAT STROKE • More severe symptoms of heat exhaustion • Sweating may or may not be present • Red or flushed, hot, dry skin • Bizarre behavior • Mental confusion or losing consciousness ## WHAT TO DO • Call 911 for emergency medical assistance • Keep the victim lying down with their head lower than their feet. • Loosen the victim's clothing. • Give fluids if possible. Avoid ice water and alcohol. Salt solutions are best. Remember: Heat illness can be life threatening. The body is reacting to a life threatening situation. Do not take chances. Prevent Heat illness by being proactive.

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## Heat Kills Heat illness includes heat cramps, fainting. heat exhaustion, and heatstroke. Workers have died or suffered serious health problems from these conditions. Heat illness can be prevented. ## Know the symptoms of heat illness Watch for symptoms in yourself and your coworkers. If you feel any symptoms, tell your coworkers and supervisor immediately because you may need medical help. Know who to talk to and how to get help before you start each workday. Life-threatening symptoms High body temperature Red, hot, dry skin Confusion Convulsions Fainting Early symptoms Fatigue Heavy sweating Headache GET Cramps MEDICAL HELP Dizziness High pulse rate Nausea/vomiting ## Preventing Heat Illness Tell your supervisor if you are new to working in the heat or have had heat illness before. Stay alert to the weather During a heat wave you are at greater risk of getting sick. You need to watch yourself and coworkers more closely, and may need to drink more water, take more breaks, and use other measures. Drink enough cool, fresh water Drink at least one 8-ounce cup (3 cones) every 15 minutes during your entire work shift. Do not wait until you are thirsty to drink water. ## Do not drink alcohol. Avoid coffee. Choose water over soft drinks. Take rest breaks in the shade to cool down. Wear proper clothing Loose fitting, light-weight and light-colored cotton clothes, a wide-brimmed hat or cap, and a bandana. Talk to your doctor if you have illnesses like diabetes, are taking medicines or are on a low salt diet. ## Know Your Rights If you work outdoors, by law, your employer must provide you: • Enough cool, fresh drinking water throughout the day. • Access to shade or an equally cool spot for at least 5 minutes at a time. • Training on how to prevent heat illness and how to call for emergency services. For more information call the worker hotline at 1-[redacted phone] California Department of Industrial Relations STATE OF CALIFORNIA CAL O…

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CPWR TOOLBOX RESEARCH AND TRAINING THE CENTER FOR CONSTRUCTION TALK Hot Environments Exposure to extreme heat can result in illness and injury. Working in a hot environment can cause heat stroke, heat exhaustion, heat cramps, or heat rash. In addition, heat increases the risk of injury for workers because of sweaty palms, fogged-up safety glasses, and dizziness. Burns also can occur when a worker comes in contact with a hot surface or steam. ## Ben's Story Ben had been outside for several hours in extremely hot temperatures laying brick. He began to feel nauseated, his head ached, and he was sweating heavily. His supervisor noticed Ben was working much slower than usual and asked him how he felt. When he heard the symptoms, he called 911, took Ben to the shade, gave him a cool drink, and wetted him with cool water and ice. - Have you or someone you know ever experienced a heat-related illness on the job? If so, what happened? - What can you do to help avoid heat-related illnesses? ## Remember This ➤ Your employers should train you on heat hazards and their plan to prevent heat-related illnesses. - Take frequent breaks in the shade or in air conditioning. - Drink plenty of water - stay hydrated. During moderate work in the heat for less than 2 hours, you should drink 1 cup (8 ounces) of water every 15–20 minutes. If you will be sweating for several hours, you will need sports drinks. Avoid alcohol, caffeine, and sugar. ## Recognize the signs of heat illnesses in yourself and your co-workers: - Signs of heat stroke include - confusion ○ hot, dry skin or profuse sweating - slurred speech ○ unconsciousness - seizures ° high body temperature - Signs of heat exhaustion include - headache - nausea - dizziness ○ thirst 。 heavy sweating - weakness - o high body temperature ○ irritability ○ low urine output If a co-worker has signs of heat exhaustion: Call 911. Get the worker to shade and cool them down by removing clo…