Heat Stress Health Hazards - Occupational Safety and Health ...

Heat Stress Health Hazards - Occupational Safety and Health ...

Heat Stress Health Hazards osha.gov University of Puerto Rico Medical Sciences Campus Susan Harwood Training Grant SH29650-SH6 Disclaimer This material was produced under Susan Harwood grant number SH29650-SH6 Occupational Safety and

Health Administration, U.S. Department of Labor. The contents in this presentation do not necessarily reflect the views or policies of the U.S. Department of Labor, nor does the mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government .. Objectives Identifying heat illnesses related signs and symptoms

Recognition and Evaluation of heat stress in the occupational environment Proposing effective means for minimizing and preventing heat stress exposure Heat Stress Exposure to heat can cause illness and death. The most serious heat illness is heat stroke. Other heat illnesses, such as heat exhaustion, heat cramps and heat rash, should also be avoided!

In addition, repeated exposure to sunlight can cause skin cancer! Climate Effects Observed in Puerto Rico A series of extreme climate events were observed in Puerto Rico during the summer of 2012: From May through July 2012 there were 42 days with temperatures 90F, with 30 days in a row above 90F between June and July. The summers of 2012 and 2013 are considered the hottest summers on record as well as the longest hot spells in San Juan,

Puerto Rico 42 days in the summer of 2012 had temperatures above 90% of all temperatures ever recorded for that period in the year 30 days in the summer of 2013 had temperatures above 90% of all temperatures ever recorded for that period in the year Information Source: Extreme Heat Events in San Juan Puerto Rico: Trends and Variability of Unusual Hot Weather and its Possible Effects on Ecology and Society. Investigators: Mndez-Lzaro P, Martnez-Snchez O, Mndez-Tejeda R, Rodrguez E, Morales E, Schmitt-Cortijo, N. J Climatol Weather Forecasting 3:135. do:10.4172/2332-2594.1000135 (2015)

Climate Effects Observed in Puerto Rico Air Surface Temperature Statistics for San Juan, Puerto Rico 1981-2013 Information Source: Extreme Heat Events in San Juan Puerto Rico: Trends and Variability of Unusual Hot Weather and its Possible Effects on Ecology and Society. Investigators: Mndez-Lzaro P, Martnez-Snchez O, Mndez-Tejeda R, Rodrguez E, Morales E, Schmitt-Cortijo, N. J Climatol Weather Forecasting 3:135. do:10.4172/2332-2594.1000135 (2015) Climate Effects Observed in Puerto Rico 1-Air Surface Temperature Statistics for San Juan, Puerto Rico 1981-2013

Information Source: Extreme Heat Events in San Juan Puerto Rico: Trends and Variability of Unusual Hot Weather and its Possible Effects on Ecology and Society. Investigators: Mndez-Lzaro P, Martnez-Snchez O, Mndez-Tejeda R, Rodrguez E, Morales E, Schmitt-Cortijo, N. J Climatol Weather Forecasting 3:135. do:10.4172/2332-2594.1000135 (2015) Climate Effects Observed in Puerto Rico 2-Temperatures Luis Muoz Marn International Airport

Laguna San Jos Information Source: A Heat Vulnerability Index to Improve Urban Public Health in San Juan, Puerto Rico Investigators: Pablo Mndez-Lzaro, Frank E. Muller-Karger , Daniel Otis , Matthew J. McCarthy, Ernesto Rodrguez. International Journal of Biometeorology (Submission Number: IJBM-S-16-00246) Climate Effects Observed in Puerto Rico 3-Temperatures Rio Piedras Botanic Garden

Information Source: A Heat Vulnerability Index to Improve Urban Public Health in San Juan, Puerto Rico Investigators: Pablo Mndez-Lzaro, Frank E. Muller-Karger , Daniel Otis , Matthew J. McCarthy, Ernesto Rodrguez. International Journal of Biometeorology (Submission Number: IJBM-S-16-00246) Climate Effects Observed in Puerto Rico 4- Illnesses In Puerto Rico, strong evidence suggests that the heat effect causes an excess risk of non-accidental mortality:

Stroke AND Cardiovascular diseases were the primary cause of death most associated with elevated summer temperatures for 2012 and 2013 Stroke Summers of 2009 and 2010 Summers of 2012 and 2013 Relative Risk = 6.22 Relative Risk = 16.80 Cardiovascular Diseases

Summers of 2009 and 2010 Summers of 2012 and 2013 Relative Risk = 9.57 Relative Risk = 16.63 Information Source: Climate Change, heat and mortality in the tropical urban area of San Juan-Puerto Rico Investigators: Pablo A. Mndez-Lzaro, Cynthia Prez-Cardona, Ernesto Rodrguez, Odalys Martnez, Rafael Mndez-Tejeda, Mariela Taboas1, Arelis Bocanegra. International Journal of Biometeorology (Accepted in Press: IJBM-D-16-00214R1)

Climate Effects Observed in Puerto Rico 5- Heat effects Heat effect causes an excess risk of non-accidental mortality! Information Source: Climate Change, heat and mortality in the tropical urban area of San Juan-Puerto Rico Investigators: Pablo A. Mndez-Lzaro, Cynthia Prez-Cardona, Ernesto Rodrguez, Odalys Martnez, Rafael Mndez-Tejeda, Mariela Taboas1, Arelis Bocanegra. International Journal of Biometeorology (Accepted in Press: IJBM-D-16-00214R1) What happens to our body when it is exposed to heat?

Fatigue (physical + mental) Heart rate

Blood pressure Activity of digestive organs Core temp. Shell temp. Blood flow to skin Sweat Physiology and Temperature Body functions best with core temperatures close 1-20 F to 98.6O F Between 100-102F body performance drops

sharply At temperatures above 105F, sweating mechanism may fail Heat Control Process in our Body sensory Heat sensitive nerves (sensors) Heat Control Process in our Body

temperature control Heat center control (thermostat) Heat sensitive nerves (sensors) Heat Control Process in our Body summary 1. Heat transported

by blood to skin 2. Blood circulation to disperse heat equally 3. Secretion of sweat Heat center controls (thermostat) Heat sensitive nerves (sensors)

Heat Storage or Loss in our Body S = M +/- C +/- R E S: heat storage (or loss) of the body M: Heat gain of metabolism C: Heat gained (or lost) due to convection

R: Heat gained (or lost) due to radiation E: Heat lost trough evaporation of sweat Important Heat Disorders and Their Symptoms Source: https://www.osha.gov/SLTC/heatillness/edresources.html Factors Affecting Susceptibility to Heat Individual Factors

Age Weight Degree of physical fitness and acclimatization Metabolism Environmental Factors Air temperature Temperature of surrounding surfaces Relative humidity

Air movement How can we measure environmental heat? How can we measure environmental heat? Preventive measures Source: https://www.osha.gov/SLTC/heatillness/edresources.html Recommendations for Lower Risk when HI

<91F Provide drinking water Ensure that adequate medical services are available Plan ahead for times when heat index is higher, including worker heat safety training Encourage workers to wear sunscreen Acclimatize workers If workers must wear heavy protective clothing, perform strenuous activity or work in the direct sun, additional precautions are recommended to protect workers from heat-related illness.

Recommendations for Moderate Risk when HI is between 91F to 103F Remind workers to drink water often (about 4 cups/hour) Review heat-related illness topics with workers: how to recognize heat-related illness, how to prevent it, and what to do if someone gets sick Schedule frequent breaks in a cool, shaded area Acclimatize workers Set up buddy system/instruct supervisors to watch workers for signs of heat-related illness

If workers must wear heavy protective clothing, perform strenuous activity or work in the direct sun, additional precautions are recommended to protect workers from heat-related illness.* Schedule activities at a time when the heat index is lower Develop work/rest schedules Monitor workers closely Recommendations for High Risk when HI is between 103F to 115F Alert workers of high risk conditions Actively encourage workers to drink plenty of water (about 4

cups/hour) Limit physical exertion (e.g. use mechanical lifts) Have a knowledgeable person at the worksite who is wellinformed about heat-related illness and able to determine appropriate work/rest schedules Establish and enforce work/rest schedules Adjust work activities (e.g., reschedule work, pace/rotate jobs) Use cooling techniques Watch/communicate with workers at all times When possible, reschedule activities to a time when heat index is lower

Recommendations for Very High Risk when HI >115F Reschedule non-essential activity for days with a reduced heat index or to a time when the heat index is lower Move essential work tasks to the coolest part of the work shift; consider earlier start times, split shifts, or evening and night shifts. Strenuous work tasks and those requiring the use of heavy or non-breathable clothing or impermeable chemical protective clothing should not be conducted when the heat index is at or

above 115F. If essential work must be done, in addition to the steps listed above: Alert workers of extreme heat hazards Establish water drinking schedule (about 4 cups/hour) Develop and enforce protective work/rest schedules Conduct physiological monitoring (e.g., pulse, temperature, etc.) Stop work if essential control methods are inadequate or unavailable. When Under Direct Sunlight or Exposed to High Radiant Heat Content We Should Use Another Parameter

1. We should measure: Natural wet bulb temperature Globe temperature Dry bulb temperature Then combine them into WBGT

2. Measure Average Heart Rate doing the task When Under Direct Sunlight or Exposed to High Radiant Heat Content We Should Use Another Parameter (cont.) 3. Take into account if worker is acclimatized or non acclimatized 4. Use WBGT limits and implement acclimatization plan if necessary

WBGT Limits For Unacclimatized Workers Table data Adapted by Sergio A. Caporali Filho from Criteria for Recommended Standards: Occupational Exposure to Heat and Hot Environments Investigators:Brenda Jacklitsch, MS; W. Jon Williams, PhD; Kristin Musolin, DO, MS; Aitor Coca, PhD; Jung-Hyun Kim, PhD; Nina Turner, PhD Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health WBGT Limits For Acclimatized Workers Table data Adapted by Sergio A. Caporali Filho from

Criteria for Recommended Standards: Occupational Exposure to Heat and Hot Environments Investigators:Brenda Jacklitsch, MS; W. Jon Williams, PhD; Kristin Musolin, DO, MS; Aitor Coca, PhD; Jung-Hyun Kim, PhD; Nina Turner, PhD Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health NIOSH Recommended Acclimatization Plan Gradually increase exposure time in hot environmental conditions over a period of 7 to 14 days. For new workers, the schedule should be no more than 20% of the usual duration of work in the hot environment on day 1 and a no more than 20% increase on each additional day. For workers who have had previous experience with the job,

the acclimatization regimen should be no more than 50% of the usual duration of work in the hot environment on day 1, 60% on day 2, 80% on day 3, and 100% on day 4. The time required for nonphysically fit individuals to develop acclimatization is about 50% greater than for the physically fit. Stay safe and healthy osha.gov

OSHA Poster osha.gov Preventing heat illness References Extreme Heat Events in San Juan Puerto Rico: Trends and Variability of Unusual Hot Weather and its Possible Effects on Ecology and Society. Investigators: Mndez-Lzaro P, MartnezSnchez O, Mndez-Tejeda R, Rodrguez E, Morales E, SchmittCortijo, N. J Climatol Weather Forecasting 3:135. do:10.4172/2332-2594.1000135 (2015)

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