Western Kentucky UniversityTopSCHOLAR®

Nursing Faculty Publications School of Nursing

2015

Mine Workers, Heat Related Illnesses, and the Roleof the Occupational Health NurseKim BourneWestern Kentucky University, kimberly.bourne@wku.edu

Follow this and additional works at: http://digitalcommons.wku.edu/nurs_fac_pub

Part of the Occupational and Environmental Health Nursing Commons, and the Public Healthand Community Nursing Commons

This Article is brought to you for free and open access by TopSCHOLAR®. It has been accepted for inclusion in Nursing Faculty Publications by anauthorized administrator of TopSCHOLAR®. For more information, please contact topscholar@wku.edu.

Recommended CitationBourne, K. (2015). Mine workers, heat related illnesses, and the role of the occupational health nurse. Kentucky Nurse, 63(3), 6-7.

J u ly , A u g u s t, S e p te m b e r 2 0 1 5P a g e 6 • K e n tu c k y N u rs e

Mine Workers, Heat Related Illnesses, and the Roleof the Occupational Health Nurse

Kimberly M. Bourne, MSN, RN, SANE, CEN Student: University of Kentucky Occupational/Environmental

Health Nurse PhD Fellow Faculty Mentor: Dr. Deborah Reed

A cross th e U n ited S ta te s , w orkers in m a n y o cc u p a tio n s face w ea th e r a n d re la ted ex tre m e con d itio n s on a daily b as is . Hot w e a th e r a n d m a n u a l lab o r in c re a se a p e rso n ’s core body te m p era tu re . T h is h e a t g a in com es from a co m b in a tio n of e n v iro n m en ta l a n d se lf-generated (or in te rn a l) h ea t. E n v iro n m en ta l h e a t is b o th w e a th e r re la ted a n d m an -m ad e , a n d in te rn a l h e a t is p ro d u ced from m etabo lic p ro c e sse s (Xiang, Bi, P isan iello , & H an sen , 2014). B u t, it’s j u s t n o t th e h e a t th a t c a u se s prob lem s; it’s th e hum id ity , too. E a c h y e a r th o u s a n d s of w orkers su ffe r h e a t re la ted illn e sse s a s a re s u lt of beco m in g overheated . B etw een Ju n e , 2013 a n d Ju ly , 2014, h e a t re la ted illn e sse s w ere resp o n sib le for m ore th a n 20 o cc u p a tio n a l w orker d e a th s in th e U. S. (O ccupational S afety a n d H ea lth A d m in is tra tio n [OSHA], 2014). M iners a re a t a n in c re ase d r isk for h e a t re la ted illn esses . W orkers in u n d e rg ro u n d m in e s a re exposed to a m b ien t te m p e ra tu re s a n d relative h u m id ity w hile p e rfo rm in g th e ir jo b d u tie s decked o u t in sa fe ty equ ipm en t. S u rfac e m in e w orkers e n d u re ou td o o r e n v iro n m en ta l te m p e ra tu re s u n d e r th e sa m e sa fe ty p recau tio n s . T he a im of th is p a p e r is to o u tlin e th e v a rio u s h e a t re la ted illn e sse s su ffered by coal m in e rs , su m m a riz e th e fin d in g s from sev era l p u b lish ed s tu d ie s , offer su g g e stio n s to O ccu p a tio n a l H ea lth N u rses for red u c in g h e a t ex p o su re in m in e rs , a n d p ro p o se fu tu re d irec tio n s for re se a rc h .

B ackgroun dW orldwide, app rox im ate ly 2 4 ,0 0 0 coal m in e s ex is t (World Coal

A ssocia tion , n.d.). In th e U nited S ta te s , th e re a re 1,061 coal m in e s w ith 877 coa l m in e s in th e A p p a la ch ian region of th e U nited S ta te s (U.S. E nergy In fo rm atio n A d m in is tra tio n [ElA], 2015b). T he A p p a la ch ian region s tre tc h e s from S o u th e rn New York to N o rth ern A lab am a a n d in to E a s te rn M ississippi. C e n tra l A p p alach ia (Kentucky, T en n essee , W est V irg in ia , a n d V irginia) is h o m e to 525 coal m ines: 2 4 8 u n d e rg ro u n d m in e s a n d 277 su rfa ce m in e s (EIA, 2015b). In 2013, 18,853 people w ere em ployed in u n d e rg ro u n d C en tra l A p p a la ch ian m ines, a n d 9 .0 8 9 people w ere em ployed in C e n tra l A p p a la ch ian su rfa ce m in e s (EIA, 2015a). C oal m in in g is considered one of th e m ost d an g e ro u s jo b s in th e w orld, a n d each d ay m in e rs a re exposed to a v a rie ty of h a z a rd s , b o th fa ta l a n d non-fa ta l.

In 2014, th e re w ere 16 fa ta litie s in coa l m in e s a c ro ss th e U nited S ta te s (M ine S afe ty a n d H ea lth A d m in is tra tio n [MSHA], n .d .a). Ten of th e fa ta litie s

Compassion has to be taught by example. At Spencerian College,

we ensure our graduates have the knowledge - and the em pathy -

to make a difference in the lives o f the ir patients.

If you are looking fo r an em otionally rewarding career, consider nursing.

Spencerian has helped hundreds o f aspiring healthcare workers

become licensed practical nurses (LPNs) and registered nurses (RNs).

>: . -W — ^ i B — — HHB— Ir ............. ' ...................... ................ ' ........................ • ■

i Spencerian College 502-447-1000V Quality Education Since 1892 s p e n c e ria n .e d u

Spencerian College’s Practical Nursing diptoma and Associate of Applied Science in Nursing are approved by the Kentucky Board of Nursing.

For more information about program successes in graduation rates, placement rates and occu­pations, please visit spencerian.edu/programsuccess.

o c c u rre d In th e A p p a la ch ian region, a n d n in e from th e A p p a la ch ian reg ion w ere in C e n tra l A p p a lach ia (MSHA, 2015). M ost fa ta litie s w ere re la ted to p h y sica l h a z a rd s su c h a s falls, exp losions, a n d eq u ip m en t acc id en ts (D onoghue, 2004a). H eat, a lso considered a p h y sic a l h a z a rd , h a s co n trib u te d to ap p ro x im ate ly 150 m in e rs su ffe rin g from som e ty p e of non- fa ta l h e a t re la ted illn ess (MSHA, n.d.c) su c h a s h e a t stroke , h e a t e x h a u s tio n , h e a t c ra m p s, a n d h e a t r a s h (C enters for D isease C ontro l a n d P reven tion [CDC], 2014; Lutz, Reed, T urner, & L ittau , 2014; OSHA, n.d.). H eat re la ted illn esse s a re a lso th e c a u se of in ju rie s re su lt in g from falls a n d eq u ip m en t o p era tio n ac c id en ts (W ash ing ton S ta te D e p a rtm e n t o f L abor & In d u s tr ie s , n.d.) a s w orkers develop sy m p to m s su c h a s sw ea ty p a lm s , confusion , se izu re s , d izziness, fatigue, h a llu c in a tio n s , a n d m u sc le c ra m p s (CDC, 2014).

T y p es o f H eat R ela ted I lln e s s e s

H eat S trok eH eat s tro k e is th e m o s t se rio u s h e a t re la ted illn e ss a n d c a n q u ick ly re su lt

in d e a th if n o t tre a te d (Lutz e t al., 2014; OSHA, n.d.). It is a s so c ia te d w ith c e n tra l n e rv o u s sy s tem d y sfu n c tio n a n d is ch a ra c te r iz e d by a h ig h core body te m p e ra tu re (above 104°F), confusion , a ta x ia , n a u s e a a n d vom iting , ta c h y c a rd ia , ta ch y p n e a , a n d h ead ach e (D onoghue, 2 0 04b ; Keim, G uisto , & S u llivan , 2002). C om plications include: h em o rrh ag e , a c u te re n a l failu re , rhabdom yolysis, a n d liver fa ilu re (Donoghue, 2004b ; G lazer, 2005).

H eat E x h a u stio nH eat e x h a u s tio n is th e m o s t com m on h e a t re la ted illn ess a n d is th e re su lt

of d eh yd ra tion . S igns a n d sym ptom s include: a core body te m p e ra tu re b e tw een 98 .6°F a n d 104°F, d izz iness, w e a k n e ss , h ea d ac h e , a n d syncope (D onoghue, 2004b ; G lazer, 2005). C om plications a re le ss severe th a n h e a ts tro k e a n d include: hypo tension , o ligu ria , ta c h y c a rd ia , a n d con fusion (Glazer, 2005).

H eat C ram psH eat c ra m p s a re often th e f irs t s ig n o f a h e a t re la te d illn ess a n d a re

ch a ra c te r iz e d by in v o lu n ta ry c o n tra c tio n s of th e sk e le ta l m u sc le s . H eat c ra m p s a re p a in fu l, c a n o cc u r in th e legs or abdom en , a n d u su a lly la s t a few m in u te s (D onoghue, 2004b ; Keim e t al., 2002).

H eat R ashA H eat r a s h is th e le a s t se rio u s h e a t re la ted illn ess . It is th e re s u lt of

clogged p o res from ex p o su re to h ig h h e a t a n d hum id ity . It is c h a ra c te r iz e d by tin y red b u m p s, or b lis te r like a re a s on th e su rfa ce of th e s k in from sw eat tra p p e d u n d e r th e sk in (Keim e t al., 2002).

The H eat E ffec t on M inersH eat is a com m on prob lem in th e m in in g in d u stry . S u rfac e m in e rs a re

freq u en tly exposed to h ig h w et-bu lb globe te m p e ra tu re s , e sp ec ia lly d u r in g th e su m m e r m o n th s w h en it c a n exceed 30°C (H unt, P arker, & S tew art, 2013). “T he W et B u lb G lobe T e m p era tu re (WBGT) is a m e a su re of th e h e a t s tr e s s in d ire c t su n lig h t, w h ich ta k e s in to acco u n t: te m p e ra tu re , hum id ity , w in d speed , s u n ang le a n d cloud cover (solar rad ia tion ). T h is d iffers from th e h e a t index , w h ich ta k e s in to co n s id e ra tio n te m p e ra tu re a n d h u m id ity a n d is ca lc u la te d for sh a d y a r e a s ” (N ational W eath er S ervice, 2015, p a ra . 1). U n d erg ro u n d m in e rs a re v u ln e ra b le to h e a t a c c u m u la tio n a s th e re s u lt of h ig h h e a t flow from th e e a r th , h e a t from v irg in rock, a n d a d d itio n a l sa fe ty eq u ip m en t su c h a s se lf-co n ta in ed se lf-rescue a p p a ra tu s e s (MSHA, n.d.b; Lutz e t al., 2014; X iang e t al., 2014). M ost h e a t re la ted il ln e sse s o c c u r d u r in g day ligh t h o u rs w hen th e te m p e ra tu re s a re h ig h e r (X iang e t al., 2014). In a s tu d y of th re e m in e s ite s a c ro ss n o r th e rn A u s tra lia , 87% of su rfa c e m in e rs (n=91) a n d 79% of u n d e rg ro u n d w o rk ers (n=56) rep o rte d ex p e rien c in g a t le a s t one sym ptom of a h e a t re la te d illn ess d u r in g th e ir sh ift, a n d 81- 82% rep o rted sy m p to m s m ore th a n once d u r in g th e ir sh ift. S eventy-one p e rc en t of su rfa c e m in e rs w ere d eh y d ra ted p rio r to s ta r t in g th e ir sh if t w ith s im ila r n u m b e rs in u n d e rg ro u n d m in e rs (H unt, P arker, & S tew art, 2013). In a s im ila r s tu d y of a m in e b la s t crew in th e tro p ic s (n=15), 73% of w orkers com p la in ed of a t le a s t one sym ptom of a h e a t re la ted illn e ss d u r in g th e ir sh ift, a n d 88% w ere d eh y d ra ted p rio r to th e b e g in n in g of th e ir sh if t (H unt, Parker, & S tew art, 2014). In each study , th e d e h y d ra tio n s ta tu s d id n o t im prove d u r in g th e sh if t (H un t e t al., 2013; H u n t e t al., 2014). In th e U.S., b e tw een J a n u a ry , 1983 a n d D ecem ber, 2001, 538 m in e w o rk ers re p o rte d a t le a s t one sym ptom of a h e a t re la ted illn e ss d u r in g th e ir sh ift, a n d 79.4% of th e in c id en ts o c c u rre d d u r in g th e su m m e r m o n th s (D onoghue, 2004b).

T he O ccu p ation a l H ea lth N urse’s R ole in C om b atin g H eat R ela ted I lln e s s e s

T h ere a re severa l fac to rs th a t p u t m in e rs a t a n in c re a se d r is k for h e a t re la ted illn esses: hy p o h y d ra tio n , in c re a se d body m a s s in d e x (BMI), poor aerob ic fitn e ss , a n d la ck of h e a t acc lim a tio n (B rake, 2001; D onoghue, S incla ir, & B a tes, 2000). O ccu p a tio n a l h e a lth n u r s e s c a n help d ec rease th e r is k of sy m p to m s re la ted to h e a t illn e sse s by p ro v id in g ed u c a tio n a n d developing p ro g ra m s a n d policies to en c o u rag e h y d ra tio n b o th p rio r to a n d a f te r w orker sh if ts a s a h ig h n u m b e r re p o r t to d u ty h y p o h y d ra te d a n d d u r in g sh if ts a s th e y co n tin u e to dep lete th e ir f lu id s (B rake, 2001;

July, August, September 2015 Kentucky Nurse • Page 7

K alkow sky & K am p m an n , 2006). F itn ess p ro g ra m s se rv e a d u a l p u rp o se ; th e y c a n help d e c re a se BMI a n d in c re a se aerobic f itn e ss a s h ig h e r BMI’s h av e b ee n positively co rre la te d w ith a n in c re a se in h e a t illn e sse s (D onoghue & B ates, 200 0 ; Lutz e t a l„ 2014). T he developm ent of acc lim a tio n p ro g ra m s a n d se lf-pacing p ro g ra m s c a n red u c e th e in c id en ces of sy m p to m s of h e a t re la ted illn e sse s by p ro m o tin g s h o r te r w ork -rest cycles, e n c o u rag in g w o rk ers to r e s t m ore often, w o rk in g a t slow er ra te s in h ig h e r te m p e ra tu re s , a n d re p o rtin g sy m p to m s e a r lie r (D onoghue e t al., 2 0 0 0 ; H u n t e t a l., 2014; X ian g e t al., 2014).

C o n c lu sio nM ost s tu d ie s on h e a t re la ted illn esse s in

m in e rs have o c c u rre d o u ts id e of th e U. S. T hose s tu d ie s have sh o w n th a t a s ig n ific an t n u m b e r of m in e w o rk ers re p o rte d a t le a s t one sym ptom of a h e a t re la ted illn e ss d u r in g th e ir a s s ig n e d sh ift. D eh y d ra tio n w as no ted to be th e lead ing c a u se of h e a t e x h a u s tio n espec ia lly d u r in g th e su m m e r m o n th s . E d u ca tio n a n d th e developm ent of p ro g ra m s a n d policies by o ccu p a tio n a l h e a lth n u r s e s c a n help co m b at th e in c id en ces of h e a t re la te d illn e ss sy m p to m s. As lim ited d a ta e x is t on h e a t re la ted i l ln e sse s in m in e rs in th e U.S., m ore re s e a rc h is n eed ed to d e te rm in e th e p o te n tia l effects of h e a t ex p o su re on h e a t re la ted illn e sse s in m in e w o rk ers in th e A p p a la c h ia n reg ion of th e U. S.

ReferencesB rak e , R. (2001). F lu id c o n su m p tio n , sw ea t ra te s

a n d h y d ra tio n s ta tu s of th e rm a lly -s tre s se d u n d e rg ro u n d m in e rs a n d th e im p lica tio n s for h e a t lo ss a n d s h o r te n e d sh if ts . Q u e en s la n d M ining In d u s try O ccupational H ea lth a n d S a fe ty Conference. T ow nsville , A u s tra l ia . R etrieved from h ttp : / /w w w .

p o in th e a lth .c o m .a u /p d f /F lu id % 2 0 c o n s u m p tio n .% 2 0 s w e a t% 2 0 ra te s % 2 0 a n d % 2 0 h v d ra tio n % 2 0 s ta tn s % 2 0 of% 2 O th e rm . pd f

C e n te rs for D ise a se C ontro l a n d P rev en tio n . (2014). H eat stress . R etrieved from h ttp :/ /w w w .c d c .g o v /n io sh / to p ic s /h e a ts t r e s s /

D onoghue, A. (2004). O ccu p a tio n a l h e a lth h a z a rd s in m in in g : A n overview. O ccupational M edicine. 54, 2 8 3 - 2 89 . doi: 10.1 0 9 3 /o cc m ed /k q h 0 7 2

D onoghue, A. M. (2004b). H eat illn e ss in th e U.S. m in in g in d u s try . A m erica n Jo u rn a l o f In d u str ia l M edicine. 45. 351-356 . doi: 10.1 0 0 2 /ajim . 10345

D onoghue, A. M., & B a tes , G. P. (2000). T he r is k of h e a t e x h a u s tio n a t a d eep u n d e rg ro u n d m eta llife ro u s m in e in re la tio n to su rfa c e te m p e ra tu re s . O ccupational M edicine. 50(4), 3 3 4 -3 3 6 . doi: 10 .1093/ o c c m e d /5 0 .4 .2 5 9

D onoghue, A. M., S in c la ir, M. J ., & B a tes , G. P. (2000). H ea t e x h a u s tio n in a deep u n d e rg ro u n d m eta llife ro u s m in e . O ccupational a n d E nvironm enta l M edicine. 57(3). 165-174. d o i:1 0 .1136 \oem .57.3.165

G lazer, J . L. (2005). M an ag em en t of h e a ts tro k e a n d h e a t e x h a u s tio n . A m erican Fam ily P hysician, 71(11), 2133-2140 . R etrieved from h ttp :/ /w w w .a a fn .o rg / a fp /2 0 0 5 /0 6 0 1 /p 2 1 3 3 .p d f

H u n t. A. P., P a rk er, A. W., & S te w a rt, I. B. (2013). S y m p to m s of h e a t i lln e ss in su rfa c e m in e w o rkers. In terna tiona l A rch ives o f O ccupational a n d E nvironm enta l H ealth , 86 , 519-527. doi:10 .1007/S 0 0 4 2 0 -0 1 2 -0 7 8 6 -0

H u n t, A. P., P a rk er, A. W., & S te w a rt, I. B. (2014). H eat s t r a in a n d h y d ra tio n s ta tu s o f su rfa c e m in e b la s t c rew w o rkers. Jo u rn a l o f O ccupational a n d E nvironm en ta l M edicine, 56(4), 40 9 -4 1 4 . doi:10 .1097/ JOM.OOOOOOOOOOOOOl 14

K alkow sky, B., & K a m p m a n n , B. (2006). Physio logical s t r a in of m in e rs a t h o t w o rk in g p lac es in G e rm an co al m in es . In d u str ia l H ealth , 44 , 4 6 5 -4 7 3 .d o i:1 0 .2 4 8 6 /in d h e a lth .4 4 .4 6 5

Keim, S.M., G u isto , J.A ., S u lliv a n J r , J .B . (2002). E n v iro n m e n ta l T h e rm a l S tre ss . A n n a ls A gricultural a n d E nvironm enta l M edicine, 9(1), 1-15. R etrieved from h ttp : / / w w w .a a em .p i/p d f/a a em 0 2 0 1 .p d f

Lutz, E. A., Reed, R. J . , T u rn er, D., & L ittau , S. R. (2014). O c cu p a tio n a l h e a t s t r a in in a ho t u n d e rg ro u n d m e ta l m in e . Jo u rn a l o f O ccupational a n d

E nvironm enta l M edicine, 56(4). 3 8 8 -3 9 6 . doi: 10 .1097/ JO M .0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 7

M ine S afe ty a n d H e a lth A d m in is tra tio n . (2015). Coal m ining fa ta li tie s b y s ta te b y ca len d a r year. R etrieved from U n ited S ta te s D e p a rtm e n t of L abor: h t tp : / /w w w . m sh a .g o v /s ta ts /c h a r ts /c o a lb v s ta te s .p d f

M ine S afe ty a n d H e a lth A d m in is tra tio n , (n .d .a). Coal fa ta li tie s fo r 1900 through 2014. R etrieved from h t tp : / / w w w .m s h a .g o v /s ta ts /c e n tu rv s ta ts /c o a ls ta ts .a s p

M ine S afe ty a n d H e a lth A d m in is tra tio n , (n.d.b). H eat S tre ss in Mining. R etrieved from h ttp : / /w w w .m s h a . g o v /s & h in fo /h e a ts t r e s s /m a n u a l/h e a tm a n u a l .h tm

M ine S afe ty a n d H e a lth A d m in is tra tio n , (n.d.c). H eat s tre ss ...w h a t to do. R etrieved from h ttp : / /w w w .m s h a . g o v /s & h in fo /h e a ts tre s s /h e a ts tre s s .h tm

O c cu p a tio n a l S a fe ty a n d H e a lth A d m isitra tio n . (2014). H eat F atalities. R etrieved from h ttp s ://w w w .o sh a .g o v / S L T C /h e a til ln e ss /m a p te x t.h tm l

O ccu p a tio n a l S a fe ty a n d H e a lth A d m in is tra tio n , (n.d.). O ccupational h e a t exposure. R etrieved from h t tp s : / / w w w .o sh a .g o v /S L T C /h e a ts tre s s /in d ex .h tm l

W orld C oal A sso c ia tio n , (n.d.) R esources. R etrieved from h t tp s : / /w w w .w o r ld c o a l .o r g / r e s o u r c e s / f r e q u e n t ly - a sk e d -o u e s t io n s /

N a tio n a l W ea th er S erv ice . (2015). W etB ulb Globe tem perature. R etrieved from h ttp : / /w w w .s rh .n o a a . g o v /tsa /? n = w h g t

U.S. E n erg y In fo rm atio n A d m in is tra tio n . (2015a). A verage n u m b er o f em p lo yees b y s ta te a n d m ine type, 2013 a n d 2012. R etrieved from U.S. D e p a r tm e n t of E n erg y A n n u a l C oal R eport: h ttp ://w w w .e ia .g o v /co a l/ a n n u a l /n d f / ta b le l8 .p d f

U.S. E nergy In fo rm atio n A d m in is tra tio n . (2015b). Coal production a n d n u m b er o f m in es b y s ta te a n d m ine type, 2013 a n d 2012. R etrieved from U.S. D e p a r tm e n t o f E nergy A n n u a l C oal re p o rt: h ttp ://w w w .e ia .g o v / coal /a n n u a 1 /p d f/t.a b le l .pdf

W ash in g to n S ta te D e p a r tm e n t o f L abor & In d u s tr ie s , (n.d.). O utdoor h e a t exposure. R etrieved from h t tp : / / w w w .l n i .w a . g o v / s a f e t v / t o p i c s / a t . o z / h e a t s t r e s s / d e fau lt.a sp

X iang , J ., Bi, P., P isan ie llo , D.. & H a n se n , A. (2014). H e a lth im p a c ts of w o rkp lace h e a t ex p o su re : An ep idem iological review . In d u str ia l H ealth , 52, 91-101. R etrieved from h ttp :/ /w w w .n c h i.n lm .n ih .g o v /p m c / a r tic le s /P M C 4 2 0 2 7 5 9 /

CEXKYKYNURSE30

KENTUCKY VALUE PACKS

ONLY $21.95EVERYDAY!

W hen o rd e r in g p lease use code

YOUR ENTIRE CE ORDER*INCLUDES OUR ALREADY DISCOUNTED BUNDLES!

W h e n o rd e r in g p lease use code

NO EXAM REQUIRED!

WESTERN SCHOOLSThe #7 Home Study Provider of Nurses' Continuing Education

► O ver 200 expertly w ritten and peer-reviewed courses ranging from 1-36 contact hours

► Com plete yo u r exam and evaluation on line —get yo u r certificate instan tly

• W e have yo u r state-required courses

Order now at w w w .w esternschoo ls .com /ky or call 1-800-438-8888 to request a FREE catalog

W ESTERN i SC HO O LS

H ome Study

Specifica lly designed w ith you r state requirem ents in m ind

Com plete yo u r Value Pack on line and get you r certificate instan tly !

•T h e largest, m ost experienced prov ider o f Value Packs nationw ide

Order now at www.ce-express.com/cekyor cajl 1 -8 0 0 -4 3 8 -8 8 8 8 to request a FREE Value Pack

Find the same course or Value Pack at a lower price elsewhere, and W E'LL BEAT T H A T LOWER PRICE BY 5%

f A C C R E O {T E d \ . .p r o v i d e r \ Awarded

A N C C A c c re d ita t io n w ith D is t in c t io n !