whats SEM policy on heat stress?

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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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# TOGETHER WITH TOSHA newsletter (cont.) Employers Must Be Proactive to Prevent Heat Illness In this article, Erin Pitt, Health Compliance Supervisor for TOSHA, discusses occupational heat illness in the workplace and outlines preventive measures to help protect employees. Occupational heat illness refers to a spectrum of heat-related conditions that arise from exposure to high temperatures in the workplace, particularly when physical activity is involved. These illnesses range from minor symptoms like heat cramps to life- threatening conditions such as heat stroke. With summer here, measures to prevent heat illness are more critical than ever. ## Types of Heat Illness ## Heat Cramps Painful muscle spasms, often due to loss of electrolytes through sweat. ## Heat Exhaustion Characterized by heavy sweating, weakness, dizziness, nausea, and rapid heartbeat. If untreated, it can progress to heat stroke. ## Heat Stroke A medical emergency marked by a body temperature above 104°F (40°C), confusion, loss of consciousness, and lack of sweating. Immediate medical intervention is essential. ## Heat Rash Skin irritation caused by excessive sweating. ## Rhabdomyolysis A serious condition caused by the breakdown of muscle tissue, releasing damaging proteins into the blood. ## Risk Factors • Environmental: high temperatures, humidity, direct sunlight, and poor ventilation. • Work-related: strenuous physical activity, wearing protective clothing, and lack of rest breaks. • Individual: poor physical fitness, certain medications, dehydration, or lack of heat acclimatization. ## Preventive Measures in the Workplace To reduce the risk of heat illness, employers should adopt a comprehensive heat illness prevention program that includes the following elements: ## Heat Acclimatization Gradually increasing workload and exposure for new or returning workers over seven to 14 days allows the body to adapt to heat stress. ## Hydration Provide easy access to cool dri…

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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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# 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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# Before Heat Exposure (cont.) ## During Heat Exposure (cont.) Page 2 Heat Stress 7. Monitor those around you frequently for the early signs and symptoms of heat stress. Get anyone who is showing signs of heat illness to a shaded, cool, and well-ventilated area. 8. Consider Personal Protection Equipment (PPE) use. Wearing certain types of PPE can increase core body temperature and should be monitored. Additionally, personal cooling systems (e.g., water- cooled garments and air-cooled garments) can greatly reduce core body temperature. 9. During breaks, remove PPE and loosen or remove clothing. Also, while rehydrating, use cold packs, wet towels, wearable personal cooling systems, and other cooling methods to reduce body core temperature and allow for a more rapid recovery. ## Do Not: 1. DO NOT exercise or work for more than brief periods; either in direct sunlight or outdoors between the hours of 11:00 a.m. to 4:00 p.m., unless necessary. 2. DO NOT drink just plain water in large volumes before or after intense or prolonged bouts of exercise, or if you have been sweating heavily. 3. DO NOT depend on salt tablets to replace the body electrolytes you have lost during sweating. 4. DO NOT persist in exercising or being exposed to heat if you develop any of the early warning signs of heat stress. 5. DO NOT drink alcoholic or high sugar beverages before, during, or immediately after heat stress. 6. DO NOT drive or operate machinery if you have any of the signs and symptoms of heat stress. ## After a Heat Exposure • Remove or loosen clothing and either rest in a cool, well-ventilated area, or shower with tepid or cool (not cold) water. • Drink SMALL amounts of electrolyte replacement fluids frequently during the next hour or so. - Seek medical help if you feel dizzy, faint or nauseated after you have cooled down, or if you develop muscle cramps within 24 hours of being heat exposed. ## Emergency Measures When a person shows signs of heat stress, ta…

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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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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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# 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

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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?

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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.

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# Heat Stress (cont.) ## Monitoring (cont.) 8" DEPARTMENT of LABOR US VIRGIN ISLANDS VIDOSH 70% -100° 60% 95 50% 90 40% 85" 30% 80 Lidity mpora # Heat Stress ## Prevention Proper training and preventive measures will help avert serious illness and loss of work productivity. Preventing heat stress is particularly important because once someone suffers from heat stroke or heat exhaustion, that person may be predisposed to additional heat injuries. To avoid heat stress, management should take the following steps: - Adjust work schedules: • Modify work/rest schedules according to monitoring requirements. • Mandate work slowdowns as needed. • Rotate personnel: alternate job functions to minimize overstress or overexertion at one task. • Add additional personnel to work teams. • Perform work during cooler hours of the day if possible or at night if adequate lighting can be provided. • Provide shelter (air-conditioned, if possible) or shaded areas to protect personnel during rest periods. - Maintain workers' body fluids at normal levels. This is necessary to ensure that the cardiovascular system functions adequately. Daily fluid intake must approximately equal the amount of water lost in sweat, i.e., 8 fluid ounces (0.23 liters) of water must be ingested for approximately every 8 ounces (0.23 kg) of weight lost. The normal thirst mechanism is not sensitive enough to ensure that enough water will be drunk to replace lost sweat. When heavy sweating occurs, encourage the worker to drink more. The following strategies may be useful: - Maintain water temperature at 50° to 60°F (10° to 15.6°C). • - Provide small disposable cups that hold about 4 ounces (0.1 liter). • Have workers drink 16 ounces (0.5 liters) of fluid (preferably water or dilute drinks) before beginning work. . Urge workers to drink a cup or two every 15 to 20 minutes, or at each monitoring break. A total of 1 to 1.6 gallons (4 to 6 liters) of fluid per day are recommended, but mor…

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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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# 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…

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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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# 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…