May/June 2020
By Nancy Mann Jackson
Heat-related illnesses can be serious. A heat-stress program that includes risk
assessment, training, and policies and procedures for encouraging hydration and cooling off can reduce the risks.
One day last June, as employees at Berman Bros. in Jacksonville, Fla., worked in the hot Florida sun, one worker started feeling unwell. The temperature was around 90 degrees Fahrenheit that day, Safety Manager Nick Sowers recalls, and the employee was welding inside a warehouse that is not climate-controlled. “After he returned from lunch, he appeared lethargic and was telling co-workers that he just didn’t feel right,” Sowers says.
Knowing that feelings of dizziness and nausea from the heat can quickly give way to more severe symptoms, the worker’s supervisor alerted Sowers. With the symptoms and the employee’s other medical conditions, Sowers didn’t want to take any risks. He transported the employee to the local emergency room for evaluation. Fortunately, “we identified the signs [of dehydration] and got the employee taken care of before it became a major health concern,” Sowers says. The employee was treated for dehydration and returned to work the following day without restrictions.
Safety training, communication, and empowerment kept this incident from becoming more serious. “I really rely on my guys to communicate with me and use their stop-work authority,” Sowers says. “The policies we have in place work, it’s just about making sure the management team stays involved and keeps the conversation going with the team throughout the hot season.”
Working in the heat—whether in hot summer weather or while undertaking hot work such as torchcutting—is often uncomfortable. But that heat also can expose workers to serious illnesses such as heat exhaustion and heatstroke, which can be deadly if not treated right away. Recycling facilities don’t have to be in the hottest parts of the country to face heat-related hazards. Any facility that experiences hot temperatures, high humidity, or direct sun exposure should consider its risk factors for heat illness, according to the Occupational Safety and Health Administration. And some workers may be at higher risk of heat-related illnesses, ISRI’s environment, health, and safety department says, based on the type of work they’re doing and how strenuous it is, how accustomed they are to the heat, whether they’re adequately hydrated, and whether they have pre-existing medical conditions.
Help workers avoid heat illness by understanding your risks and responsibilities and developing proactive measures to mitigate those risks.
Understand the risks
“Heat rash, heat cramps, heat exhaustion, [and] heatstroke are all forms of heat illness,” says Tony Smith, ISRI’s director of safety outreach. “A person can go from slight discomfort from a mild rash to muscle spasms and pain with cramping to dizziness, nausea, and vomiting, right up to fainting and seizures with heatstroke,” he says. “It’s important for employers to know the signs and symptoms and have a plan in place to avoid heat illness in your workplace.” (See “Symptoms of Heat-Related Illness” at left.) Heat can also indirectly increase the risk of injuries if it results in sweaty palms or fogged-up safety glasses, or if it heats a metal surface in the environment enough to cause burns.
Even covered or indoor facilities can pose heat risks. Electronics recycler HOBI International (Dallas) has an electronics dismantling area in the back of one of its three facilities that’s not air conditioned. Approximately 20 employees work in that part of the facility, using hand and electric tools to take apart PCs, laptops, and other electronic equipment. “It gets pretty hot in there,” says Craig Boswell, HOBI’s president. “When it’s 105 degrees outside in the summer, it’s probably in the 90s in that building.”
For companies that have multiple facilities, “conditions vary depending on the area,” says Tamara Deiro, director of safety and RIOS management representative for SA Recycling (Orange, Calif.). “Our Southeast yards experience humidity, where our Arizona yards tend to experience dry heat.” She explains that “a person that works outside in a dry environment will sweat, but the sweat evaporates much quicker, thus cooling the body down [more] than in a humid environment. In a humid environment, a person’s sweat will not evaporate like it does in dry heat because there is already water in the air, so it ends up causing the body to heat up instead of cool down. We should hydrate even more when it is humid,” she says, and “you benefit from wearing clothing that aids in pulling the moisture away from your body. It’s just like wearing microfiber shirts at the gym.”
At SA Recycling facilities, “we refer to the heat index from the National Weather Service to know what the weather is expected to ‘feel like,’” Deiro says. “The NWS also has a great heat index calculator that we use as well.” She cautions that “there is no ‘one-size-fits-all’ guidance. Each manager needs to be aware of his situation and act accordingly.” For metal processors, Sowers says, “yards need to be mindful that the heat reflects off the metal that we store at our facilities, and temperatures can be much higher in the yard than what the news or Internet says.”
Workers with certain preexisting health conditions face a higher risk for heat-related illnesses. Those likely at increased risk include workers who are elderly, diabetic, or have high blood pressure. Workers who have recently made changes in medications or who drink lots of caffeinated beverages can also be more vulnerable, ISRI’s Smith says.
Newer employees, or any employee who is not acclimated to working in the heat, can be at increased risk as well. In a small study by California’s Division of Occupational Safety and Health, almost half of the incidents of heat-related illness involved a worker who was on his or her first day of work; 80% of the cases involved a worker who had only been on the job for four or fewer days. “It can take a body five to seven days to become acclimated to a new environment,” Smith says. “That’s why it’s important to gradually increase the workload or allow more frequent breaks, to help new workers and those returning to a job after time away build up a tolerance for hot conditions.”
Assess, plan, and train
OSHA does not have a specific standard that addresses heat-related hazards, but under the Occupational Safety and Health Act, employers have a duty to protect workers from recognized serious hazards in the workplace, and this includes heat-related hazards, Smith says. (California, Washington, and Minnesota have their own heat-related worker safety standards; Minnesota’s standard only applies to indoor work.) The risk of heat-related illness should be part of each job hazard assessment, he says. Once you’ve assessed and determined where you face risks of heat-related illness, develop a plan for responding. OSHA’s online resources can help; go to www.osha.gov/heat/. Typical strategies include educating workers on the risks and implementing policies and procedures that can reduce the risk.
Every heat stress program should include regular training to teach staff members how to recognize the signs and symptoms of heat-related illness as well as the importance of hydration, personal health, and hygiene, Smith says. “The more educated and trained eyes that you have on the situation, the better your chances of success will be in the event that someone on your team is showing signs of distress,” he says.
SA Recycling provides heat illness training during new-hire orientation, “whenever we see someone deviating from our procedures, when there is an incident, and in an annual refresher training program,” Deiro says. The company also conducts “tailgate meetings” when there is a sudden shift in the weather, when there are long periods of hot weather, and when employees are required to work outside in the heat to get a project done, she says. The SA training stresses the importance of not drinking anything that contains a lot of caffeine or sugar. “Often, employees think that Gatorade is a good drink that can replace their electrolytes, but it contains high levels of sugar,” Deiro says. A 20-ounce serving of Gatorade contains 34 grams of sugar. “If the employees really want to drink something other than water, we suggest the G2 Gatorade,” she says. A 20-ounce serving of G2 has 11.7 grams of sugar, and Gatorade Zero has no sugar. Sqwincher is another brand of hydration drinks and popsicles Deiro calls a good option. Its original, EverLyte, and Zero product lines roughly correspond to the original, G2, and Zero lines of Gatorade in terms of sugar levels.
At Berman Bros., employees also undergo training on heat stress during their orientation as new hires and annually at a companywide safety meeting each May. The transition period between spring and summer is the most dangerous because employees have not built a tolerance to the heat yet, Sowers says. He follows OSHA’s training guidelines, educating the team on the various types of heat-related illnesses, the effects, and how to prevent them. He also recommends the free mobile app OSHA and the National Institute for Occupational Safety and Health offer (www.cdc.gov/niosh/
topics/heatstress/heatapp.html), which provides the heat index for your location, an hourly heat-index forecast, risk-based recommendations, heat illness symptoms, first-aid information, training, and more.
Annual training is crucial, as it’s easy to forget the potential severity of heat-related illnesses and how to prevent them from year to year. “The biggest thing people need to understand is that if you wait until you’re thirsty to get water, it’s too late,” HOBI’s Boswell says. “That’s the biggest misconception, that if you just drink when you feel thirsty, you’ll stay hydrated. Also, a lot of people are not aware of what milder feelings of dehydration are. To keep it from getting severe, we want people to know [those symptoms] so they can take care of it.”
Policies and procedures
Workplace policies and procedures can reduce the risk of heat illness. “Remember these three words: water, rest, shade,” Smith says. “These should be practiced at all times if there is a possibility of a heat-related illness on the job.” At a minimum, policies should address how the facility will provide water, shade, and opportunities for employees to rest in a cool place.
Other approaches could include reworking employees’ schedules to take advantage of cooler hours of the day. During the hottest months in Jacksonville, workers arrive at Berman Bros. earlier than usual, and they try to schedule any strenuous work in the morning. “For example, if we have a blade flip planned on the shear, the team will come in an hour early or so to take advantage of those cooler hours,” Sowers says. “Due to our geographical location, our employees are at risk [for heat illness] probably nine months out of the year,” he adds. “Because we are based in Florida, every employee is exposed to the extreme heat. Our maintenance team is probably [at] the highest risk due to constant movement all over the yard and working on equipment in the field with no [air conditioning].”
SA Recycling also will change employees’ schedules as needed if they must work in the sun, “having them come in really early so that they are done before the heat is at its highest,” Deiro says. “The late afternoon sun can just be brutal.” If the surrounding neighborhood is amenable and yard lighting sufficient, an overnight shift is one option, she says. “The [general managers] are really good at working with the employees and will allow them to come in at 2, 3, or 4 a.m. if warranted.”
Most scrap facilities require employees to wear protective clothing and personal protective equipment, which can make it more difficult to stay cool. Berman Bros.’ requirements include long pants, at least a ¾-sleeve shirt, steel-toed boots, safety glasses, and hard hat. In addition, employees conducting torching operations must wear burn sleeves and burn goggles. SA Recycling also recommends long-sleeved shirts for its outdoor workers. Deiro says they’re a good choice despite the heat. “The long sleeve will protect the employee’s skin from the sun and, depending on the fabric, will absorb their sweat” or allow the sweat to evaporate, if it’s a cotton fabric or moisture-wicking fabric, respectively.
“It’s also strongly encouraged that the employee wear sunscreen whenever [he or she is] required to work outside,” she adds. “Some people believe they don’t need sunscreen when it is overcast outside, [but] a person should use sunscreen even on those days,” she says. Even if it feels cooler on cloudy days, the risk of sunburn remains, as 80% of UV rays can pass through clouds.
Rest, water, and shade strategies vary from company to company. At Berman Bros., from May to September or October, managers position five-gallon water coolers in all the work areas and supply the employees with a hydrating drink mix, Sowers says. During days of extreme heat, supervisors pass out electrolyte ice pops and fruit. Employees always have access to air-conditioned buildings and equipment cabs, and he patrols the yard, encouraging them to take frequent breaks and hydrate, he says.
SA Recycling has rest areas with water, shade, and seating throughout its yards. The rest areas have either small refrigerators or coolers with individual water bottles or large water jugs with disposable cups. When the temperature exceeds 95 degrees Fahrenheit, heat breaks become mandatory, Deiro says. The supervisor will start the day with a tailgate meeting and will discuss the expected weather and the requirements for the employees to stay hydrated, to look out for their fellow co-workers, to notify their supervisor if they need a break, and to listen for the required heat-break notification. The frequency of mandatory heat breaks depends on the temperature and the scope of work being done, she says, and they’re typically five-10 minutes each.
During the heat breaks, the supervisors should be assessing their employees for signs of heat stress, Deiro says. Some yards offer employees cooling wraps for their neck or cooling caps that go inside the hard hat. Employees also have access to air-conditioned break rooms, and SA’s policies require that equipment cabs have functioning air-conditioning units.
HOBI provides water and fans for the workers in the un-air-conditioned part of its Dallas facility, and it uses secured chain-mesh curtains instead of doors across loading docks to maximize cross-ventilation in the facility. Signs throughout work areas and in the bathrooms remind employees of the signs of dehydration and encourage them to stay hydrated.
Responding to signs of heat stress
Even when you provide proper training and procedures to reduce the risk, it’s not uncommon to have an employee who reaches a level of heat stress. When that happens, acting quickly can often improve the situation and avoid a more severe illness.
“We’ve had workers get headaches and nausea from dehydration,” Boswell says. When that happens, supervisors bring the employee into an air-conditioned area and instruct him or her to sip water and cool down. HOBI also provides Pedialyte popsicles, which helps employees rehydrate faster.
Different levels of heat stress require different levels of intervention. If the employee is experiencing a heat rash, move the worker to a cooler, less-humid environment and try to keep the affected area dry, Smith says. However, if the person is cramping, he or she needs to rest in a cool area, drink water or other cool beverages, and wait a few hours before going back to strenuous work. If the cramps don’t go away, the person should seek medical attention. If the employee has heat exhaustion—symptoms include fatigue, irritability, thirst, nausea or vomiting, dizziness or lightheadedness, heavy sweating, and elevated body temperature or fast heart rate—he or she needs to rest in a cool and shady area, have plenty of water or other cool beverages available to drink, and have a cold compress or other means available to cool the body. If the symptoms do not improve within one hour, take the person to the emergency room for medical evaluation or treatment, Smith says. “If this is the case, then the person should not return to work that same day,” he adds.
If someone has a heatstroke—symptoms include confusion; slurred speech; unconsciousness; seizures; heavy sweating or hot, dry skin; very high body temperature; and rapid heart rate—call 911. While waiting for help, Smith says, put workers with heatstroke in a cool and shady area, loosen tight or restrictive clothing, fan them, put cold packs under their armpits, wet them with cool water, give them fluids—especially water and sports drinks—and stay with them until help arrives.
Someone can have symptoms of multiple heat-related illnesses at the same time, thus it’s important to promptly provide first aid when any
of the symptoms are present, according to OSHA’s Heat-Related Illnesses and First Aid page. “Time is of the essence” to prevent these conditions from worsening, the page states.
Nancy Mann Jackson is a freelance writer based in Madison, Ala.