Prevent heat illness before symptoms appear

Preventing heat illnesses requires planning and controls. Once an employee shows symptoms of heat illness, the employee must stop working to recover and might even need time off. Recognizing signs of heat illness is important, but preventive measures should ensure that workers don’t experience symptoms.

Prevention measures and controls should prevent symptoms from developing. The National Institute for Occupational Safety and Health (NIOSH) recommends the following to prevent heat-related illnesses:

• Monitor the weather and develop a plan for when a heat wave is forecasted.
• Create a buddy system where workers observe each other for symptoms of heat-related illness to allow for early intervention.
• Provide a cooler place, ideally a shaded or air-conditioned area, and encourage workers to take breaks. Adjust the frequency and duration of breaks based on temperature, humidity, sunlight, and physical tasks. Remember that wearing PPE can increase the risk of heat-related illnesses.
• Ensure that cool, potable water is readily available and encourage workers to hydrate before, during, and after work. For moderately intense work lasting less than two hours, workers should drink approximately one cup of water every 15 to 20 minutes.  During prolonged sweating lasting several hours, workers should drink sports drinks containing balanced electrolytes.
• Acclimate workers by gradually increasing workloads so their bodies adjust to working in the heat.
  

Training workers

Because susceptibility to heat stress varies by individual (age, weight, health conditions, etc.), training is key so employees can self-monitor and watch out for each other. Employers should provide heat stress training that covers:

• Identifying and controlling heat hazards and understanding risk factors.
• Recognizing the signs and symptoms of heat-related illnesses.
• Causes of heat-related illnesses and steps to reduce the risk, like drinking enough water and monitoring the color and amount of urine output.
• Individual factors that may impact workers’ risk for developing a heat-related illness.
• Proper care and use of heat-protective clothing and equipment
• The heat load caused by exertion, clothing, and personal protective equipment.
• The importance of acclimatization.
• Immediately reporting any symptoms or signs of heat-related illness, first aid procedures, and contacting emergency medical services.
  

OSHA inspections

In 2022, OSHA launched a National Emphasis Program on heat illness prevention (CPL 03-00-024). The document directs OSHA compliance officers to consider the following questions during a heat illness prevention inspection:

• Is there a written program?
• How did the employer monitor ambient temperature(s) and levels of work exertion at the worksite?
• Was unlimited cool water easily accessible to employees?
• Did the employer require additional breaks for hydration?
• Did the employer schedule rest breaks?
• Did employees have access to a shaded area?
• Did the employer provide time for acclimatization of new and returning workers?
• Was a “buddy” system in place on hot days?
• Were administrative controls used (earlier start times, employee/job rotation) to limit heat exposures?
• Did the employer provide training on heat illness signs, how to report signs and symptoms, first aid, how to contact emergency personnel, prevention, and the importance of hydration?
  

OSHA does not yet have a regulation on heat illness prevention, so the agency cannot cite for things like not developing a written plan. However, OSHA can use the General Duty Clause to cite employers for recognized hazards. The above considerations could help an employer show that its actively trying to protect workers from heat illnesses.