How to Be Safe Working in Extreme Heat

It has been a hot week here in the NYC/NJ area, as well as along the entire Northeast, with the heat index (apparent temperature) exceeding 100°F.

Here’s how to stay safe when working outdoors.

Receive proper training. This post is intended as a courtesy reference and should not be considered as medical advice. You can call me Dr. Stuey if you’d like (explained here), but I am not a medical doctor.

If you are working outdoors in extreme heat (where the heat index exceeds 100°F), your employer is responsible for your training and safety. If they do not provide this training, you should still know and understand the risks and preventative measures just the same.

More Info: OSHA, CDC, CDC Quick Ref., CDC Outdoor Workers, NIOSH

Try not to work in direct sunlight.

Drink plenty of water. This means water, preferably cool water, but a Gatorade or sports drink here and there should be okay. OSHA recommends at least one pint of water per hour. The CDC recommends 2-4 cups per hour of work.

Personally, I aim for one liter of water per hour of strenuous outdoors activity during peak hours. I rarely drink that much, but it’s what I know I should be drinking.

Avoid alcoholic or sugar-laden drinks. Soda is not water.

Drink before you’re thirsty. OSHA recommends taking a drink every 15 minutes regardless of thirst.

Avoid heavy physical labor during peak hours. Don’t exert yourself unless you must.

Take breaks. Don’t wait until you are overcome by the heat. Take breaks in shaded or air conditioned areas. Continue replenishing fluids between breaks.

Wear appropriate clothing. Certain materials breathe better than others, and some have UPF ratings, which are a measure of protection against UV rays.

Clothes should be lightweight and loose fitting. Dark colors absorb solar radiation better, so lighter colors are preferable.

Avoid waterproof clothing that traps in sweat and increases your skin temperature.

If you’re not wearing a hardhat and are permitted to wear a hat, do so.

Sunblock. Apply in the morning, and reapply during the day. Sports-related sunblock products are generally decent. (Does anyone have tips about sunblock that can be reapplied during the day without getting gross and gritty?)

Heat Exhaustion and Heat Stroke

Heat Stress can lead to different types of heat-related illnesses, such as heat cramps, heat rash, heat syncope (fainting), heat exhaustion, and heat stroke. Heat exhaustion and heat stroke are often considered more severe, and are discussed below.

Signs of heat exhaustion:

• headache or dizziness
• extreme weakness or fatigue
• fast, weak pulse
• fast and shallow breathing
• heavy sweating and moist skin
• muscle cramps
• pale or flush complexion
• irritability
• confusion
• thirst, nausea, vomiting

First Aid: rest in a cool area, drink plenty of cool water or other beverages, and take a cool shower or bath if possible. Wiping your body down with a cool wet cloth or towel might help.

Signs of heat stroke:

• confusion
• high body temperature
• inability to think clearly
• loss of coordination
• fast, strong pulse
• passing out
• seizure
• no sweating or very profuse sweating
• slurred speech
• hallucinations
• chills
• throbbing headache

First Aid: REQUEST IMMEDIATE MEDICAL ASSISTANCE (911) and [then] contact a supervisor. Until help arrives, move the worker to a cool or at least shaded area. Remove excess clothing and apply cool water to skin. Fan them, spray them with water, soak their clothes with water, or sponge them with cool water.

Heat stroke occurs when the body’s temperature has risen too much and has become uncontrollable. The body’s self-cooling sweating mechanism has failed and the body can no longer cool itself. Death or permanent injury can result if heat stroke is not treated by emergency medical professionals quickly enough.

Prevention

Know the risks and warning signs. Drink water and enough of it. Take breaks and cool down. Check on your coworkers and have them check on you.

Don’t be foolish. It’s smart, not wimpy, to drink often and to take breaks.

Heat exhaustion does not normally require emergency medical assistance, but do not hesitate to request aid if you or a coworker needs it. Heat stroke is a life-threatening condition that absolutely requires emergency first aid.

Read these references and understand what they say:

OSHA Quick Guide (PDF)
NIOSH Fast Facts (PDF)
CDC Info for Outdoors Workers
CDC Workplace Safety Info: Heat Illness
CDC Info About At-Risk Groups

Once again, this post is not medical advice and should not be thought of as such. The information provided here is intended as a reminder that heat illness should be taken seriously. Take proper precautions, know the warning signs and symptoms, and please be safe.