Cal/OSHA Consultation ServiceCal/OSHA Consultation Service

20082008

Heat Illness PreventionHeat Illness Prevention Title 8 Section 3395Title 8 Section 3395

Heat Illness PreventionHeat Illness Prevention “Safety Basics”“Safety Basics”

POTABLE DRINKING WATER

SHADE ALLOWING THE BODY TO COOL

PREVENTATIVE RECOVERY PERIODS

EMPLOYEE/SUPERVISOR TRAINING

WRITTEN PROCEDURES

Enforcement ExperienceEnforcement Experience25 Serious Heat-Related Illnesses25 Serious Heat-Related Illnesses

May – November 2005May – November 2005

Agriculture 38%Agriculture 38%

Construction 29%Construction 29%

Service 12.5%Service 12.5%

Transportation 12.5%Transportation 12.5%

Public Safety 8%Public Safety 8%

What was discovered…What was discovered…

68% of employees spoke Spanish68% of employees spoke Spanish

Ages 17 to 76 yrs Ages 17 to 76 yrs

84% of cases involved outdoor work84% of cases involved outdoor work

92% of work was moderate 92% of work was moderate strenuous strenuous

46% of cases happened the 46% of cases happened the 11st dayst day on the job on the job

36% required hospitalization for more than 24hrs36% required hospitalization for more than 24hrs

54% of cases resulted in death of the employees54% of cases resulted in death of the employees

Environmental & Physiological Environmental & Physiological FactorsFactors

Average Average

Ambient air temperature 96Ambient air temperature 96º F º F (75 - 116º F)(75 - 116º F)

Humidity 29% Humidity 29% (12% - 55%)(12% - 55%)

Wind speed 7mphWind speed 7mph

Core body temperature 104º FCore body temperature 104º F (98 - 108º F)(98 - 108º F)

Worksite ConditionsWorksite Conditions

Potable water present - 100% of casesPotable water present - 100% of cases

Shade available - 77% of casesShade available - 77% of cases

80% of employers had a written IIPP80% of employers had a written IIPP

20% had written Heat Illness Prevention 20% had written Heat Illness Prevention PolicyPolicy

36% had an Emergency Action Plan36% had an Emergency Action Plan

Worksite ConditionsWorksite Conditions

Heat Wave - a sudden and Heat Wave - a sudden and temporary rise of temperature temporary rise of temperature above the seasonal average for a above the seasonal average for a particular region, which last for a particular region, which last for a prolonged period of timeprolonged period of time

Greatly increases the risk of heat Greatly increases the risk of heat illnessesillnesses

Heat Wave ImpactHeat Wave ImpactTemps/Day/Date/CasesTemps/Day/Date/Cases

80

85

90

95

100

105

110

115

0123456789

# Reported

Temp Kern CoSat

Mon

TueSun

Note: Direct Relationship Between Temps and Number of Reported Cases84% of the Cases Occurred During the July 2006 Heat Wave

Historical Temp

from UC IPM CIMIS

Worksite ConditionsWorksite Conditions

Heat Illness Prevention During Heat WavesHeat Illness Prevention During Heat Waves

Take Extra Measures - Take Extra Measures - More VigilanceMore Vigilance

Supervisors/employees watch each other very Supervisors/employees watch each other very closely & provide more frequent feedbackclosely & provide more frequent feedback

Avoid working alone - “buddy system”Avoid working alone - “buddy system”

Designate person - closely monitor/report Designate person - closely monitor/report employees conditionsemployees conditions

Account for employee whereabouts throughout Account for employee whereabouts throughout the work shift and end of the daythe work shift and end of the day

Worksite ConditionsWorksite Conditions

Heat Illness Prevention During Heat WavesHeat Illness Prevention During Heat Waves

Take Extra Measures - Take Extra Measures - More WaterMore Water

Employees should drink small quantities of Employees should drink small quantities of water more frequently before, during and after water more frequently before, during and after workwork

Effective replenishment of extra supplies of Effective replenishment of extra supplies of waterwater

Encourage employees to consult with their Encourage employees to consult with their doctor on salt/mineral replacementdoctor on salt/mineral replacement

Worksite ConditionsWorksite Conditions

Heat Illness Prevention During Heat WavesHeat Illness Prevention During Heat Waves

Take Extra Measures - Take Extra Measures - More CoolingMore Cooling

Use other cooling measures in addition to shadeUse other cooling measures in addition to shade

Spraying body with water/wiping with wet Spraying body with water/wiping with wet towelstowels

Additional/longer breaks in the shadeAdditional/longer breaks in the shade

Worksite ConditionsWorksite Conditions

Heat Illness Prevention During Heat WavesHeat Illness Prevention During Heat Waves

Take Extra Measures - Take Extra Measures - Change ScheduleChange Schedule

Start work earlier or later in the eveningStart work earlier or later in the evening

Split-up work shifts - avoid working in hotter Split-up work shifts - avoid working in hotter parts of the dayparts of the day

Cut work shifts short or stop workCut work shifts short or stop work

Worksite ConditionsWorksite Conditions

Heat Illness Prevention During Heat WavesHeat Illness Prevention During Heat Waves

Take Extra Measures - Take Extra Measures - Change MealsChange Meals

Encourage employees to:Encourage employees to:

Eat smaller/more frequent meals ( less body Eat smaller/more frequent meals ( less body heat during digestion than with big meals)heat during digestion than with big meals)

Choose foods with higher water content (for Choose foods with higher water content (for example, fruits, vegetables, salads)example, fruits, vegetables, salads)

Worksite ConditionsWorksite Conditions

Heat Illness Prevention During Heat WavesHeat Illness Prevention During Heat Waves

Acclimatization WarningAcclimatization Warning

Even employees previously fully Even employees previously fully acclimatized are at risk for heat illnessacclimatized are at risk for heat illness

Body needs time to adjust to sudden, Body needs time to adjust to sudden, abnormally high temperatures or other abnormally high temperatures or other extreme conditionsextreme conditions

Heat Illness PreventionHeat Illness Prevention 3395(a) Scope and Application3395(a) Scope and Application

Applies to the control of Applies to the control of

risk of occurrence of heat risk of occurrence of heat

illnessillness in all outdoor in all outdoor

places of employmentplaces of employment

Does not exclude other Does not exclude other

Title 8 requirements, Title 8 requirements,

such as, IIPP, drinking such as, IIPP, drinking

water, first aidwater, first aid

3395(b) Definitions3395(b) Definitions

“ “ Heat IllnessHeat Illness"" means a serious means a serious

medical condition resulting from themedical condition resulting from the

body's inability to cope with a body's inability to cope with a

particular heat load, and includesparticular heat load, and includes

heat cramps, heat exhaustion, heat cramps, heat exhaustion,

heat syncope and heat stroke.heat syncope and heat stroke.

""Environmental risk factors for heat illnessEnvironmental risk factors for heat illness""

means working conditions that create the possibility that heat means working conditions that create the possibility that heat

illness could occur, includingillness could occur, including air temperature, relative humidity, air temperature, relative humidity,

radiant heat from the sun and other sources, conductive heat radiant heat from the sun and other sources, conductive heat

sources such as the ground, air movement, workload severity sources such as the ground, air movement, workload severity

and duration, protective clothing and personal protective and duration, protective clothing and personal protective

equipment worn by employees. equipment worn by employees.

““Personal risk factors for Personal risk factors for

heat illnessheat illness”” means factors such means factors such

as an individual’s age, degree of as an individual’s age, degree of

acclimatization, health, water acclimatization, health, water

consumption, alcohol consumption, consumption, alcohol consumption,

caffeine consumption, and use of caffeine consumption, and use of

prescription medications that prescription medications that

affect the body’s water affect the body’s water

retention or other physiological retention or other physiological

responses to heat.responses to heat.

““AcclimatizationAcclimatization””A temporary adaptation of the body to work in the heat that A temporary adaptation of the body to work in the heat that

occurs gradually when a person is exposed to it. occurs gradually when a person is exposed to it. Acclimatization Acclimatization

peaks in most people within 4 - 14 days of regular work for at peaks in most people within 4 - 14 days of regular work for at

least 2 hours per day in the heat.least 2 hours per day in the heat.

3395(b) Definitions3395(b) Definitions

""ShadeShade"" means blockage of direct sunlight. Canopies, umbrellas means blockage of direct sunlight. Canopies, umbrellas

and other temporary structures or devices may be used to provide and other temporary structures or devices may be used to provide

shade. One indicator that blockage is sufficient is when objects do shade. One indicator that blockage is sufficient is when objects do

not cast a shadow in the area of blocked sunlight. Shade is not not cast a shadow in the area of blocked sunlight. Shade is not

adequate when heat in the area of shade defeats the purpose of adequate when heat in the area of shade defeats the purpose of

shade, which is to allow the body to cool. For example, a car sitting shade, which is to allow the body to cool. For example, a car sitting

in the sun does not provide acceptable shade to a person inside it, in the sun does not provide acceptable shade to a person inside it,

unless the car is running with air conditioning.unless the car is running with air conditioning.

""Preventative Preventative

Recovery PeriodRecovery Period““ means a period of time to means a period of time to

recover from the heat in recover from the heat in

order to prevent heat order to prevent heat

illness.illness.

3395(b) Definitions3395(b) Definitions

3395(c) Provision of Water3395(c) Provision of Water

Sufficient amounts of Sufficient amounts of cool water available at cool water available at all times w/at least one all times w/at least one quart per employee per quart per employee per hour for the entire shifthour for the entire shift

Easy access to clean and Easy access to clean and cool water encourages cool water encourages frequent drinkingfrequent drinking

Keep the water Keep the water replenished replenished

3395(d) Access to shade3395(d) Access to shade

Preventative Recovery Period (PRP)Preventative Recovery Period (PRP) is is necessary if an employee is suffering from necessary if an employee is suffering from heat illness or believes that a rest break is heat illness or believes that a rest break is needed to recover from the heat needed to recover from the heat

Employees must have access to an area Employees must have access to an area with shade that is either open to the air or with shade that is either open to the air or provided with ventilation or cooling for a provided with ventilation or cooling for a period of no less than 5 minutesperiod of no less than 5 minutes

3395(d) Access to shade3395(d) Access to shade

Access to shade is permitted at all timesAccess to shade is permitted at all times

Non agricultural employersNon agricultural employers are are permitted cooling measures other than permitted cooling measures other than shade if alternate means are proven as shade if alternate means are proven as effective as shade in cooling the bodyeffective as shade in cooling the body

3395(e) Training3395(e) Training Recognition of Environmental & Personal Risk FactorsRecognition of Environmental & Personal Risk Factors

Procedures for Complying with the RegulationsProcedures for Complying with the Regulations

Importance of Frequent Consumption of WaterImportance of Frequent Consumption of Water

Importance of Acclimatization to Working ConditionsImportance of Acclimatization to Working Conditions

Recognition of Signs/Symptoms of Heat Illnesses Recognition of Signs/Symptoms of Heat Illnesses

Importance of Reporting Signs/Symptoms to SupervisorImportance of Reporting Signs/Symptoms to Supervisor

Procedures to Follow When Heat Illness is Reported Procedures to Follow When Heat Illness is Reported

Procedures to Contact Medical Services Procedures to Contact Medical Services

Means & Methods Available to Transport Ill WorkersMeans & Methods Available to Transport Ill WorkersProcedure to Ensure Clear/Concise Directions are Given Procedure to Ensure Clear/Concise Directions are Given to Emergency Medical Responders to Locate the Worksiteto Emergency Medical Responders to Locate the Worksite

Employee TrainingEmployee Training The environmental and The environmental and

personal risk factors for heat personal risk factors for heat illnessillness

Importance of frequent Importance of frequent consumptions of small consumptions of small quantities of waterquantities of water

Importance of Importance of acclimatizationacclimatization

Different types of heat Different types of heat illness, common signs and illness, common signs and symptomssymptoms

Employee TrainingEmployee Training

Importance of immediately reporting signs/symptoms of heat illness to supervisor

Procedures for responding to possible heat illness

Procedures for contacting and directing emergency medical services to the worksite

Section 3395(e)(1)Section 3395(e)(1)Employee TrainingEmployee Training

Employers procedures Employers procedures that ensure clear and that ensure clear and precise directions to the precise directions to the work site will be provided work site will be provided to emergency medical to emergency medical service providers.service providers.

Procedures to follow when contacting Procedures to follow when contacting emergency medical services and if necessary emergency medical services and if necessary transporting employeestransporting employees

3395(e)(2) Supervisor Training3395(e)(2) Supervisor Training

Same information required under Same information required under employee training employee training PLUSPLUS

Procedures to follow to implement the Procedures to follow to implement the applicable provisions of the standardapplicable provisions of the standard

Procedures to follow when an Procedures to follow when an employee exhibits symptoms employee exhibits symptoms consistent with heat illness, including consistent with heat illness, including emergency responseemergency response

For Non-Fatal Heat Illnesses, Supervisor Trained on Heat Illness Prevention: Yes (67%) and No (33%)

Supervisor Training Conducted in Cases with Heat Related Fatality?

0

50

100

Trained Not Trained

Perc

ent

37%63%

2006 Data

Impact of Supervisor Training on the Impact of Supervisor Training on the Outcome of Heat IllnessOutcome of Heat Illness

Employer’s Written Employer’s Written ProceduresProcedures

Written policy addresses controlling the Written policy addresses controlling the risks of heat illness and includes all the risks of heat illness and includes all the elements in Section 3395elements in Section 3395

Policy and procedures can be integrated Policy and procedures can be integrated within the IIPPwithin the IIPP

Training provided to all employees to Training provided to all employees to recognize heat illness hazards before recognize heat illness hazards before starting to work outdoorsstarting to work outdoors

Procedures must be made available to Procedures must be made available to representatives of Cal/OSHA upon requestrepresentatives of Cal/OSHA upon request

ADDITIONAL GUIDANCEADDITIONAL GUIDANCE

Internet Resources – Cal/OSHA & NIOSHInternet Resources – Cal/OSHA & NIOSH

http://www.dir.ca.gov/DOSH/HeatIllnessInfo.htmlhttp://www.dir.ca.gov/DOSH/HeatIllnessInfo.html

http://http://www.cdc.gov/niosh/topics/heatstress/www.cdc.gov/niosh/topics/heatstress/