Write a toolbox talk on Warm working conditions

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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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# 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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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…

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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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# 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 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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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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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-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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# PERSONAL PROTECTIVE EQUIPMENT Date Posted: 09/03/2016 Personal Protective Equipment (PPE) is gear that can be worn to help minimize or eliminate injury. It can be worn to help prevent sudden injuries or injuries occur over time. It is very important the user understands the intended purpose of the PPE and verifies that it fits properly. that ## When to Wear PPE • Before you resort to PPE, you should first: • Use administrative controls • Implement Engineering Controls • Use local exhaust or general ventilation vs. a respirator • Control dust with a wet process vs. dry • Install sound reducing devices to mechanical equipment • When these other two means of protection are exhausted you then will need to select the appropriate PPE. - Often times PPE will be used in conjunction with administrative and engineering controls for added protection. ## BASIC TYPES OF PPE Head: Hard hat, welders cap Hearing: Earmuffs, ear plugs or canal caps Face/Eye: Safety glasses, face shield, safety goggles. Hand: Gloves for general use, chemical use, electrical work or hot work. Body: Chaps, leathers, coveralls Foot Protection: Leather boots, Safety toe/steel toe boots Personal Protective Equipment is gear that is worn to help minimize or eliminate injury. It is very important the user understands the intended purpose of the PPE, verifies that the PPE fits properly and is adequate for the work to be performed. Remember: PPE is the last line of defense against a hazard. LEARN MORE ## QUESTIONS FOR DISCUSSION • Does the PPE you wear to perform your work fit properly and is it in good working condition? What can be done in your work area to improve the use of PPE? • What improvements can be made to reduce the need for PPE? ## PRESENTER TIPS • Pre-read the Toolbox Talk. Your comfort level and confidence will be higher if you know your topic. Discuss related tasks, work areas or events that make the Toolbox Talk relevant to your job site. • Involve the workers …

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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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# TABLE OF CONTENTS (cont.) ## VIII. Objective The purpose of this REP is to prevent occupational exposure to conditions creating heat stress. This REP is targeted to keep employees from developing heat cramps, heat exhaustion, and heat stroke. Evidence from the Department of Labor, Centers for Disease Control, and NIOSH shows that elevated environmental temperatures cause hundreds of employees working both indoors and outdoors to experience heat-related illnesses and deaths annually. Excessive heat occurs from a combination of elevated temperatures, moderate or higher workloads, and high humidity. At certain levels of work, heat, and humidity, the human body cannot maintain a normal internal temperature and may experience a heat illness, including a fatal heat stroke. To prevent these illnesses and injuries, OSHA will utilize weather forecasts to determine days with hazardous heat conditions. The REP will be triggered when the National Weather Service forecasts the heat index to be at least 80° F as identified in the National Weather Service website. On those days OSHA will endeavor to ensure employers take appropriate precautions to address heat hazards. These heat illness precautions include: (1) training employees on the hazards of hot environmental temperatures, and procedures for responding to and reporting heat illness or injury (2) making appropriate first aid available, (3) having drinking water available, (4) having shade or a climate-controlled (i.e. air conditioning) area for rest breaks, (5) having a protocol to protect and acclimatize new workers and those who have just returned from an extended absence, because these workers are particularly vulnerable, and (6) having made provisions for prompt medical attention if a heat-related illness occurs. This instruction is provided to address the unsafe working conditions created by heat hazards and inappropriate safety procedures. ## IX. Scope of REP This instruction applies to indoor and outdoor wor…

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Celebrating 30 Years Kiprc KENTUCKY INJURY PREVENTION AND RESEARCH CENTER # HAZARD ALERT Kentucky Occupational Safety and Health Surveillance-August 2024 WORKING IN EXTREME HEAT AND HUMIDITY Recommendations for Employers: 4,5 What is the hazard? • Create and follow a plan to allow new and returning workers to acclimate to working in the heat. This should include shorter work periods with more frequent breaks, monitoring new workers for symptoms, and not allowing new workers to work alone. These increased precautions should last at least 1-2 weeks. • Train supervisors and workers on how to identify and control heat hazards, recognize signs and symptoms, administer first aid, and to be ready to engage emergency medical services quickly. • When possible, use methods to make the environment cooler with air conditioning, misting fans, increased ventilation, reflective shields, etc. Reduce manual workload with mechanization where possible. • Modify work schedules with mandatory increased breaks in cooler areas, scheduling work at a cooler time of day, and rotating job functions to help minimize exertion or heat exposure. • Provide cool water for workers to drink and remind workers to drink regularly, not just when thirsty. For longer jobs that exceed two hours, employers should provide electrolyte-containing beverages. • Ensure workers are wearing light colored, loose fitting clothing that doesn't trap heat or moisture. Some types of personal protective equipment can increase the risk of heat-related illness. Heat is the leading cause of death among all weather-related phenomena in the United States. From 1992 to 2022 in the United States, 986 workers across all industries died from exposure to heat. Thirty-four percent of those fatalities were in the construction industry.¹ Nearly 3 out of 4 heat-related deaths occur during a worker's first week on the job?²From 2018 to 2022, 616 Kentucky workers visited the emergency department due to heat-related illness…

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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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# 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, …