Questions and Answers About Common Heat Stress Illnesses and Preventative Measures 

In this article, we will address the symptoms of common HRI's, how to deal with the results, and investigate the benefits of a variety of preventative measures.

Question : What are the most common Heat-Related Illnesses?

Answer :

A few of the most common heat-related illnesses include:

Heat Rash:

When sweat ducts under the skin are clogged, they can cause heat rash. Heat rash manifests itself as itchy bumps, or red, blister-like eruptions.

• Prevention: Keep the skin dry, and shower after working in a hot environment.
• Treatment: Dry off sweaty skin, rest in a shaded area, and rehydrate.

Heat Cramps:

Heat cramps can result from rapid sweat loss when a person is sweating profusely. These painful spasms, usually in the legs or abdomen, are known as heat cramps.

• Prevention: If possible, avoid working during the warmest part of the day. Drink plenty of fluids, and take frequent breaks in the shade.
• Treatment: Rest in a cool or shaded area. Do some light, static stretching (no bouncing or straining), and drink an electrolyte replacement drink (which has beneficial salt and electrolytes) to replace any lost nutrients.

Heat Exhaustion:

Heat exhaustion is progressive, and usually occurs over the course of a few days. It can include headaches, weakness, mood changes, nausea, extreme sweating, and clammy skin.

• Prevention: Acclimatize to hot work environments and drink plenty of fluids.
• Treatment: Relocate to a shaded area and elevate the legs above the heart. Cool the skin, and re-hydrate. Remove any excess clothing and/or equipment to allow sweat to evaporate from the skin and re-hydrate.

Heat Stroke:

Heat stroke is the most severe HRI. Signs of heat stroke can include pale skin, nausea, vomiting, confusion, and a fever of at least 104º F.

• Prevention: Acclimatize to hot work environments and drink plenty of fluids.
• Treatment: Heat stroke constitutes a medical emergency. Body temperature must be lowered below 102º within 30 minutes of a collapse. Fluid replacement via IV may be necessary and the victim should be transported to a healthcare facility immediately. Immerse in cold water or place cool wet towels over the entire body. IMPORTANT NOTE: Medical professionals should always supervise submergence of a victim  into a tub of water.

When the heat rises at your workplace, be aware of these HRI symptoms in yourself and others. A quick response can often help avert a tragedy.

Question : If I start showing signs of heat stress, what should I do?

Answer :

Factors that increase the risk include:

• High temperatures and humidity
• Direct sun exposure and no breeze
• Heavy physical labor
• Lack of acclimatization to a hot workplace
• Low fluid intake
• Waterproof or non-breathable clothing

Both employers and workers should be familiar with the symptoms of heat stress and be able to identify when you or someone else is at risk for a heat-related illness. If someone is identified as being at risk, use the following steps as a guide to help manage the situation.

1. Move to a Shaded Area 
Whether it’s under a tree or under a break tent, it is essential to give the body a break by moving out of the sun and into a cooler place. For those showing signs of heat exhaustion, it is advisable not to return to work for the remainder of the day.

2. Remove Outer Layers of Clothing 
Removing unnecessary clothing (including jackets, shoes, and socks) can help cool a worker down more quickly. It also allows for cold compresses to reach a larger area of exposed skin.

3. Cool Down with Fans, Mist, and Ice Bags or Cold Towels 
The objective is to lower the worker’s internal body temperature. Employers should ensure that every worksite that is prone to causing HRI's is equipped with a “cooling area” (ideally with a fan), as well as a supply of ice packs for emergency situations.

4. Provide Cool Drinks for Rehydration
Individuals suffering from heat illnesses often experience some level of dehydration as well. Encourage them to take frequent sips of a cool drink (ideally water) to help replenish fluids lost in the heat.

5. Alert a Supervisor or Call 911
If someone is suffering from heat stroke and exhibiting signs confusion, loss of consciousness, and seizures, emergency services should be contacted immediately. Do not administer fluids to someone with heat stroke. While it is natural to want to help them rehydrate, the symptoms of heat stroke inhibit the victim from drinking or swallowing safely. Those suffering from heat rash, heat cramps, or heat exhaustion may also need to seek medical treatment, depending on the severity.

If at all in doubt about how to proceed, err on the side of caution, and do not hesitate to seek the help of a medical professional. Every year, thousands of workers become ill or even die from heat-related conditions. Educate yourself and take action to ensure you are not one of them.

Question : What are Electrolytes, and why do they matter?

Answer :

Electrolytes Explained

Your body runs on electricity, whether it's the neurons firing in your brain or the pumping of your heart. Electrolytes are chemicals that conduct electricity when dissolved in water. When they interact with other electrolytes and with cells, they keep the body's small electric currents flowing. Not only does this help your body's natural processes run smoothly, it is also essential to your survival.

Electrolytes are actually a family of chemicals. There are different types, each providing a different charge (either positive or negative) to trigger a reaction in the body. A few of the most common ones include:

• Magnesium
• Sodium
• Potassium
• Calcium

Electrolytes Matter for Your Day-to-Day Well-Being & Performance. Here's Why.

You know that feeling you get when you've had a really long, hard day at work and your limbs seem unusually weak? Chances are, you are experiencing an electrolyte imbalance.

It's easy to skip a break to get a few extra things done before going home, or to not bother getting up to get a refill on your drink once it's empty. But athletes aren't the only ones who need breaks and plenty of fluids. Even if you've got a desk job, you need to actively replenish your electrolytes during the day and make sure they are kept in balance.

(Not) Sweating It Out

Not sweating? Great news for your shirt, but it could be a bad sign for your body.

Sweating is your body's way of cooling itself down, and your sweat glands use electrolytes to make that happen. Water and electrolytes fill your sweat glands and get released as a salty mixture that allows the water to evaporate and cool you down. If your body doesn't have enough of one - or both - of those components, you're not going to sweat. And not sweating means your body is at risk of overheating.

Make sure you replenish your fluids regularly even if you're not sweating.

Symptoms of Electrolyte Imbalance

Depending on the type of electrolyte, different symptoms can occur when there is an imbalance. Symptoms to watch for include:

• Twitching or muscle spasms
• Confusion
• Frequent urination
• Nausea, stomach pain, or vomiting
• Extreme thirst
• Sudden moodiness or irritability
• Lethargy

If anyone displays the signs of an electrolyte imbalance, treat it immediately and call for medical assistance if necessary.

Replenishing Electrolytes

Keeping a water bottle with you at all times and taking breaks is essential, but it doesn't always mean you're in the clear.

Sports drinks and similar drinks are a popular option for maintaining a healthy electrolyte balance. There are even low-calorie and low-sugar alternatives that provide electrolyte-rich drinks to accommodate special diets.

Fluids are important, but you can also get electrolytes from what you eat. A healthy diet full of fruits and vegetables is the best way to keep your levels where they should be. People who eat a healthy diet often consume enough electrolytes to keep them going through most activities. If your job is physically demanding, however, consider supplementing with a drink designed to replenish electrolytes.

Keep in mind that some physical conditions can increase your chances of developing an electrolyte imbalance. The kidneys play a key role in monitoring electrolyte levels and filtering out the excess. If you have a kidney disease, it might affect how often you need to replenish and how quickly symptoms can set in.

If you have a chronic health condition, speak to your doctor about what you can do to maintain a healthy and functioning body throughout the day, and whether you'll need to take additional precautions to keep your electrolyte levels up.

Keep Your Levels Up

You work hard, but you also need to work smart. Make sure you are functioning at your best by keeping fluids on hand and staying on top of your electrolyte levels.

Question : Does resting in the shade really matter?

Answer :

Yes! It stands to reason that rested and cool workers are healthier, more efficient, and more productive. One way to make sure they are cool and comfortable is to let them rest in shade so the sun doesn’t sap their energy.

The Importance of Providing Shelter

When work must be done in the heat of the day, taking regular breaks and meals under the cover of shelters such as canopies, umbrellas and other temporary structures is important. So important, in fact, that some states have regulations that require it.

Providing effective jobsite shade requires planning. Shelters should block direct sunlight and if possible, provide a recovery area with access to fluids. Consider using natural shade areas with heavy tree cover, or an awning or other temporary structure at the site. Items like a misting system can cool your shelter up to 30ºF below ambient air. Air conditioned structures are ideal.

Avoid Extreme Heat

In extreme heat, working in the earlier (cooler) parts of the day – generally before 10 a.m. and after 2:00 p.m. local time – can help. If that’s not possible, however, employ smart shift scheduling to move the most intense manual labor away from the hottest part of the day.

Workers can take the matter into their own hands (and heads) by wearing wide-brimmed hard hats, hard hat brim shades and lightweight clothing on their bodies. Applying sunscreen and wearing fast-drying clothes allows sweat evaporate quickly.

Utilizing a combination of natural and temporary shade devices can shield workers from harmful UV rays and help them stay stronger for longer.

Question : How do I know when I should take a break?

Answer :

Since heat impacts people differently, opportunities for rest should be made available to workers in hot work environments whenever needed. Ideally, access to shaded and cool areas should be conveniently located near the worksite.

Acclimatization is the process of adapting to work in the heat gradually as the worker is exposed to the heat. Acclimatization peaks in most people within four to fourteen days of regular work for at least two hours per day in the heat. Elevated core temperature and heart rate can occur during the first few days of acclimatization, when the body is strained the most. This is most important for new workers, but also to those who may be exposed to heat waves. As workers become acclimated to the hotter conditions, the body regulates and the strain decreases, and in turn, work rate improves.

While individual rest periods are important, planned work-to-rest ratios are a key part of any heat stress prevention program. Once the temperature hits 75ºF (23.8ºC), work-to-rest ratios should be reevaluated and potentially readjusted. As work environment heat increases, so should the frequency and length of breaks.

Work-to-rest ratio factors to consider include:

• Temperature
• Working in direct sunlight
• Work intensity
• Clothing and PPE

Off the clock, workers should rest in a cool environment and stay hydrated. Resisting the urge to spend more time in the heat will pay off in the long run.

Question : What lifestyle choices have the biggest effects on dehydration?

Answer :

Hydration is about more than drinking fluids. Individual differences in lifestyle can increase or decrease the likelihood of dehydration. If you want to promote lifestyle changes that will help your workers get the most out of their hydration, consider educating them on the effects of diet and alcohol consumption.

You've got no say over what your employees eat. That does not mean however that you can't give them pointers about proper nutrition, especially when it could have an effect on their safety on the job. Low carb diets are still fairly popular, and some of your workers might have adopted one as part of a personal resolution. The potential problem with this is that a diet low in carbohydrates can deprive the body of water-heavy foods like whole grains. Let your workers know that if they take in a reduced amount of carbs, they might have to make up for it with higher fluid intake throughout the day.

What employees consume during the workday can also have an impact on their hydration. Items commonly found in vending machines – sodas, energy drinks, salty snacks – are especially likely to prevent the body from getting and retaining the fluids it needs to operate safely in the heat. Snacking on fruits and vegetables, on the other hand, will help them stay hydrated.

Alcohol consumption is also worth mentioning. Most people assume that since they don't drink on the job, there's no way their alcohol intake will affect their safety at work. But someone who regularly consumes alcohol will have a harder time staying hydrated due to the dehydrating effect alcohol has on the body, and the time it takes to recover.

While you can't control their lifestyle choices, educating employees on the effects of diet and alcohol intake is a good way to help them make safer decisions.

Conclusion

When working in the heat, listen to your body, and pay attention to signs that you may be getting dehydrated or developing symptoms of a Heat Related Illness. Prevention is always preferable to treatment!

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