[Image courtesy of Flickr user Bark via a Creative Commons license]So your worker is suffering from a heat-stress event. How you handle the next few minutes could determine whether and how soon the worker will get back to work – but more importantly, be able to function normally with family and friends off the job site.
A Quick Review of Heat Stress Events
In my last post, I wrote about the various levels of heat stress that go above what is considered an everyday “normal” amount of stress. When the body feels it is being pushed too hard, it can manifest its stress level in several ways, from more mild events such as edema (swelling), heat rash and muscle cramps to the more serious events like heat exhaustion, syncope and heat stroke. In this post, I will address ways to prevent these events from occurring, but if they do occur, give you a game plan to address these issues so your workers will come out OK and wil be able to return to work healthy.
Of course, the idea is to keep your workers from feeling any high levels of heat stress that could cause any of the above conditions. I will not say it is always avoiable, nor will I say that it always will happen, but it can and will be based on the individual worker. Some workers do better in heat than others. But there are steps you can take as a safety officer to encourage prevention. You could include these in your safety training for all workers, not just those who work outside or in hot environments like a warehouse or shed without a cooling system.
As was mentioned in a prior post, one of the steps to preventing these heat-stress conditions is by putting your workers through a proper acclimation process (usually about a week), where they start with a little exposure to heat and each day gradually increae that exposure, monitoring their bodies along the way. Encourage workers to hydrate well before coming to work, and allow them to have hydration available easily during their shift, and allow them to take regular breaks every hour or so so they get hydrated and get into a cooler environment.
However, even with your best efforts, these heat-stress conditions may likely happen to some workers and not to others due to various factors (covered in an earlier post). So if one of these events occurs – edema, cramps, exhaustion, etc. – what is the best way to provide first aid for these conditions?
Keeping Cool … Fast, and Often
In even the more mild events like edema or heat rash, the key is to get the worker out of the hot environment as quickly as possible, have the worker lay down somewhere cool and slowly (cannot emphasize enough) drink about four ounces of water every 15 minutes. If necessary in the interim, use cold compresses or wet cloths around the body to help cool the body down. You don’t want the body to cool down too fast, as that may adversely affect the brain and other organs by “confusing” them with blood flow going too much to other parts of the body. The cooling needs to be slow, but the body has to be moved out of the hot environment quickly.
In the more mild events, a worker might just need a few minutes, some water and a little rest and go back to work. But in a more serious case, like heat exhaustion or heat stroke, that person should be considered done for the day (even prevented from working indoors) and should be either sent home once cooled down or in the case of heat streoke, have medical attention as quickly as possible.
In the case of the more significant heat-related events, the entire body needs to be immediately taken out of the hot environment, excessive clothing removed (boots, hard hats, jackets, etc.), wrapped in cold towels or bed sheets and hydrated as much as the person is able to on his or her own. As long as the person is conscious and can drink water or Gatorade on his or her own,the worker should be advised to sip water slowly but regularly (as mentioned before). Drinking any faster may prevent the water from doing its proper cooling of the core of the body, and the water may pass through the system before being properly absorbed by the cells that need it. We do not want the person going to the bathroom; he or she needs to retain as much water as possible, so sipping slowly is very important.
Another key point – if there is more severe heat-stress event like exhaustion or syncope, get some ice packs (if available), wrap them in cloth or towels and place them at areas where there are larger blood vessels to cool those down and lessen the blood flow. These areas are the ankles and wrists, the armpits and the neck areas more prominently.
However, do not try to be a hero when it comes to heat stroke. This is a very serious matter that if not addressed quickly could result in longer-term health problems, as excessive heat for an extended period can damage vital organs. The key in these situations as get the body cooled down, laying down in a cool place and then get the person some immediate medical help. And in these situations, do not put the worker back on the schedule for work until he or she is cleared by doctors, and only then bring them back on an acclimation basis – in other words, give them a week or up to 10 days before they are able to work a full shift in the heat.
Taking these basic steps in acclimating your workers to the heat, giving them proper hydration and break opportunities, and then being aggressive in cooling the body in the case of an excessive heat-stress event can go a long way toward making your worksite safe for everyone and help minimize risks of more problems down the road.