EZ EXPLANATION OF:
Heat Stress
Heat stress is caused by a number of interacting factors, including environmental
conditions, clothing, workload, and the individual characteristics of the worker.
Because heat stress is probably one of the most common (and potentially serious)
illnesses at hazardous waste sites, regular monitoring and other preventive
precautions are vital.
Individuals vary in their susceptibility to heat stress. Factors that may predispose
someone to heat stress include:
• Lack of physical fitness.
• Lack of acclimatization.
• Age.
• Dehydration.
• Obesity.
• Alcohol and drug use.
• Infection.
• Sunburn.
• Diarrhea.
• Chronic disease.
Reduced work tolerance and the increased risk of excessive heat stress is influenced
by the amount and type of PPE worn. PPE adds weight and bulk, severely reduces
the body's access to normal heat exchange mechanisms (evaporation, convection,
and radiation), and increases energy expenditure. Therefore, when selecting PPE,
each item's benefit should be carefully evaluated in relation to its potential for
increasing the risk of heat stress. Once PPE is selected, the safe duration of
work/rest periods should be determined based on the:
• Anticipated work rate.
• Ambient temperature and other environmental factors.
• Type of protective ensemble.
• Individual worker characteristics and fitness.
Ways to Monitor
Because the incidence of heat stress depends on a variety of factors, all workers,
even those not wearing protective equipment, should be observed carefully.
• For workers wearing permeable clothing (e.g., standard cotton or synthetic work
clothes), follow recommendations for monitoring requirements and suggested
work/rest schedules in the current American Conference of Governmental Industrial
Hygienists' (ACGIH) Threshold Limit Values for Heat Stress. (The Site Manager or the
Client will provide this information) If the actual clothing worn differs from the ACGIH
standard ensemble in insulation value and/or wind and vapor permeability, change
the work/rest schedules accordingly.
• For workers wearing semi-permeable or impermeable encapsulating ensembles,
the ACGIH standard cannot be used. For these situations, workers should be
evaluated when the temperature in the work area is above 70°F (21°C).
Beyond preventative measures and observation the following can be used as
monitoring controls.
Heart rate. Count the radial pulse during a 30–second period as early as possible in
the rest period.
If the heart rate exceeds 110 beats per minute at the beginning of the rest period,
shorten the next work cycle by one–third and keep the rest period the same.
If the heart rate still exceeds 110 beats per minute at the next rest period, shorten
the following work cycle by one–third.
Oral temperature. Use a clinical thermometer (3 minutes under the tongue) or
similar device to measure the oral temperature at the end of the work period (before
drinking).
If oral temperature exceeds 99.6°F (37.6°C), shorten the next work cycle by one–
third without changing the rest period.
If oral temperature still exceeds 99.6°F (37.6°C) at the beginning of the next rest
period, shorten the following work cycle by one–third.
A workers should not wear a semi-permeable or impermeable garment when his/her
oral temperature exceeds 100.6°F (38.1°C).
Prevention
Proper training and preventive measures will help avert serious illness and loss of
work productivity. To avoid heat stress, the following steps can be taken:
Adjust work schedules:
Modify work/rest schedules according to monitoring requirements.
Mandate work slowdowns as needed.
Rotate personnel: alternate job functions to minimize overstress or
overexertion at one task.
Add additional personnel to work teams.
Perform work during cooler hours of the day if possible or at night if adequate
lighting can be provided.
Provide shelter (air–conditioned, if possible) or shaded areas to protect
personnel during rest periods.
Maintain workers' body fluids at normal levels. This is necessary to ensure that the
cardiovascular system functions adequately. Daily fluid intake must approximately
equal the amount of water lost in sweat, i.e., 8 fluid ounces (0.23 liters) of water
must be ingested for approximately every 8 ounces (0.23 kg) of weight lost. The
normal thirst mechanism is not sensitive enough to ensure that enough water will be
drunk to replace lost sweat. When heavy sweating occurs, all workers are
encouraged to drink more water.
Have workers drink 16 ounces (0.5 liters) of fluid (preferably water or sports
drinks) before beginning work.
Urge workers to drink a cup or two every 15 to 20 minutes, or at each
monitoring break. A total of 1 to 1.6 gallons (4 to 6 liters) of fluid per day are
recommended, but more may be necessary to maintain body weight.
Encourage workers to maintain an optimal level of physical fitness:
Where indicated, acclimatize workers to site work conditions: temperature,
protective clothing, and workload (see "Level of Acclimatization" at the end of
this section).
Urge workers to maintain normal weight levels.
Provide cooling devices to aid natural body heat exchange during prolonged
work or severe heat exposure. Cooling devices include:
Field cool down or hose–down areas to reduce body temperature and/or to
cool off protective clothing.
Cooling jackets, vests, or suits.
Workers should recognize signs and symptoms of heat stress and
preventative measures.
Other Factors
PPE decreases worker performance as compared to an unequipped individual. The
magnitude of this effect varies considerably, depending on both the individual and
the PPE ensemble used. This section discusses the demonstrated physiological
responses to PPE, the individual human characteristics that play a factor in these
responses, and some of the precautionary and training measures that need to be
taken to avoid PPE–induced injury.
The physiological factors that may affect worker ability to function using PPE include:
• Physical condition.
• Level of acclimatization.
• Age.
• Gender.
• Weight.
• Heat rash may result from continuous exposure to heat or humid air.
• Heat cramps are caused by heavy sweating with inadequate electrolyte
replacement. Signs and symptoms include:
• muscle spasms
• pain in the hands, feet, and abdomen.
• Heat exhaustion occurs from increased stress on various body organs
including inadequate blood circulation due to cardiovascular insufficiency or
dehydration. Signs and symptoms include:
• pale, cool, moist skin
• heavy sweating
• dizziness
• nausea
• fainting
Heat stroke is the most serious form of heat stress. Temperature regulation fails and
the body temperature rises to critical levels. Immediate action must be taken to cool
the body before serious injury and death occur. Competent medical help must be
obtained. Signs and symptoms are:
• red, hot, usually dry skin
• lack of or reduced perspiration
• nausea
• dizziness and confusion
• strong, rapid pulse
• coma
Physical Condition
Physical fitness is a major factor influencing a person's ability to perform work under
heat stress. The more fit someone is, the more work they can safely perform. At a
given level of work, a fit person, relative to an unfit person, will have:
• Less physiological strain.
• A lower heart rate.
• A lower body temperature, which indicates less retained body heat (a rise in
internal temperature precipitates heat injury).
• A more efficient sweating mechanism.
• Slightly lower oxygen consumption.
• Slightly lower carbon dioxide production.
Level of Acclimatization
The degree to which a worker's body has physiologically adjusted or acclimatized to
working under hot conditions affects his or her ability to do work. Acclimatized
individuals generally have lower heart rates and body temperatures than
unacclimatized individuals, and sweat sooner and more profusely.
This enables them to maintain lower skin and body temperatures at a given level of
environmental heat and work loads than unacclimatized workers. Sweat composition
also becomes more dilute with acclimatization, which reduces salt loss.
Acclimatization can occur after just a few days of exposure to a hot environment.
NIOSH recommends a progressive 6–day acclimatization period for the
unacclimatized worker before allowing him/her to do full work on a hot job.
When enclosed in an impermeable suit, fit acclimatized individuals sweat more
profusely than unfit or unacclimatized individuals and may therefore actually face a
greater danger of heat exhaustion due to rapid dehydration. This can be prevented
by consuming adequate quantities of water. See previous section on "Prevention" for
additional information.
Age
Generally, maximum work capacity declines with increasing age, but this is not
always the case. Active, well–conditioned seniors often have performance capabilities
equal to or greater than young sedentary individuals. However, there is some
evidence, indicated by lower sweat rates and higher body core temperatures, that
older individuals are less effective in compensating for a given level of environmental
heat and work loads. At moderate thermal loads, however, the physiological
responses of "young" and "old" are similar and performance is not affected.
Age should not be the sole criterion for judging whether or not an individual should
be subjected to moderate heat stress. Fitness level is a more important factor.
Weight
The ability of a body to dissipate heat depends on the ratio of its surface area to its
mass (surface area/weight). Heat loss (dissipation) is a function of surface area and
heat production is dependent on mass. Therefore, heat balance is described by the
ratio of the two.
Since overweight individuals (those with a low ratio) produce more heat per unit of
surface area than thin individuals (those with a high ratio), overweight individuals
should be given special consideration in heat stress situations. However, when
wearing impermeable clothing, the weight of an individual is not a critical factor in
determining the ability to dissipate excess heat.
Heat Stress Equation
