Solve the Equation

The Heat Prevention Equation

Summer heat is a real occupational hazard that both employees and employers must address. According to the Center for Disease Control (CDC) there are 702 heat-related deaths each year, 67,512 emergency departments visits of which 9235 people are hospitalized. If you dig a little deeper, heat illness has preferences. Heat deaths are most prevalent among males (69%) aged 65 and older. Statistics also show that minorities are impacted the most. Obviously, the workers the most impacted are those working outside for extended periods of time (carriers, construction workers, lawn and garden workers, and other work groups that spend significant amounts of time outside from May through September). Given what we know about the injury rates and the groups most effected, the question is how can we mitigate the effects of summer heat given the nature of the work and the exposure times? It’s an equation and a good at that.

The elements of the equation are hydration + acclimation + health & wellness + proper tools & equipment + work-rest cycles + education & awareness + core body temperatures = heat mitigation. Its an equation that both employees and employers are responsible for.

The Body’s Reaction to Heat

There are many sources that described the mechanics of heat and what happens in the human body. The simplest explanation for this process can be found in the Safety Professional’s Reference and Study Guide by W. David Yates (2015). Yates says the following:

The human body has a system of thermoregulation, which helps maintain a body temperature within a certain range. The survival range for a human is between 97°F and 100°F with a normal temperature of approximately 98.6°F. When exposed to heat extremes, the body must regulate itself to stay within this temperate range. To do so, the body must get rid of the excess heat, through varying the rate and amount of blood circulation through the skin and the release of sweat from the glands. This is accomplished when the heart begins to pump more blood, the blood vessels expand to accommodate the increased flow, and the capillaries that are located along the upper layer of the skin being to fill with blood. The blood then circulates closer to the surface of the skin, and excess heat is lost to the cooler environment. The cooled blood returns to the core of the body and picks up more heat and carriers it to the surface. This process is repeated until the core is temperate reaches a state of homeostasis.

The sweat that appears on the surface of the skin is evaporated by the cooler temperatures outside of the body. Yates (2015) goes onto further address the problem that workers experience in high heat humid environments. “The problem that is encountered in this process is that when environmental temperatures outside the body approach normal skin temperature, the cooling process becomes more difficult. However, the heart continues to pump blood to the surface of the skin, and sweat glands pour liquids containing electrolytes onto the surface of the skin, and the evaporation of the sweat becomes the principle effective means of cooling.

If sweat is not removed from the skin by evaporation, it will not cool the body. Under conditions of high humidity, the evaporation of sweat from the skin is decreased and the body’s efforts to maintain an acceptable core body temperature may be significantly impaired. With so much blood going to the external surface of the body, less is going to the active muscles, the brain, and other organs; strength declines; and fatigue occurs sooner than normal. Alertness and mental capacity also be affected. Workers who must perform delicate or detailed work many find their accuracy decrease and others may find their comprehension and retention of information lowered. Physical discomfort increases, irritability, anger, and other emotional states sometimes cause workers to overlook safety procedures or to divert attention from hazardous tasks. Combined with longer shifts, there is a greater risk of accidents and health problems.”

The remedy maybe in the heat equation. H + A + HW+ PTE + WRC+ EA + CBT = Heat Mitigation

Hydration

Hydrate before work. Being hydrated when you start work makes it easier to stay hydrated through the day. If you are dehydrated when you start work, you may not be able to drink enough to catch up with your body’s need for water.

Hydrate during work. Drink 8 oz. of water every 15 - 20 minutes while working in the heat. This translates to 24 -32 oz. per hour. Drinking water at shorter intervals is more effective than drinking large amounts infrequently. Consume healthy foods that are lighter and provide both hydration and minerals. Avoid energy drinks and drinks with high caffeine or sugar.

Hydrate after work. Most people need several hours to drink enough fluids to replace what they have lost through sweat. The sooner you get started, the less strain you place on your body from dehydration.

Acclimation

?A rule of thumb is it takes 10 to 14 days to acclimate the worker to environments, hot or cold. This process if often overlooked and misunderstood. To acclimate a worker to hot humid environments one should look to a work rest cycle and graduated workloads. Taking scheduled breaks during the hottest parts of the day for 10-15 minutes helps with both acclimation and interrupting the cumulative effects of heat. As mentioned above when the body works harder to cool, removing the worker from the environment and resting in a shaded or cooled area allows the body to reset. Graduating the workload is also an effective means of acclimation. If a worker has been away from work for extended periods, gradually increasing the workload over several days allows the worker to become accustomed to the environmental conditions.

Health and Wellness

Physical fitness matters. A more fit body is better prepared to handle the stress of the heat load imposed and created. Small activities away from work can aid in physical preparedness. Activities such as simple walks before or after the workday can assist with overall fitness. Additionally, a proper diet is vitally important. Eating foods that compliment activity matter. Avoid heavy meals during the workday. Instead focus on foods that are not processed and high in nutritional value. Foods that have high water content are also very beneficial. Sleep is very important. The body needs recovery and rebuilding time, and sleep is that time. As humans, we are all programmed to circadian rhythms. During uninterrupted sleep the body goes into the natural process of heeling. The sleep pattern should be regular. Going to sleep and waking at the same time every day has been proven to be a very powerful process that helps the mind, body, and soul. Finally, workers must address their personal health and be honest in their approach to managing those personal health issues. The most significant at-risk health factors that contribute to higher incidents of heat illness include obesity, heart disease, high blood pressure, and the medications associated with managing those issues. Workers should address their at-risk factors and their occupational exposures with their personal medical providers. Employers should provide resources to help educate workers and encourage workers to seek professional medical advice.

Proper Tools and Equipment

We know that the body is a heat engine. As the body begins to work and food is converted into usable energy, the biproduct of energy conversion is heat. Burning calories is literally metabolism. Metabolism is the process by which the body changes food and drink into energy (Mayo Clinic, 2023). As the body works harder more calories are needed. Metabolism is amplified by the both the external and internal demands the body experiences. As Yates explained earlier, the body starts to go into overdrive to keep itself cool. Using the proper tools can aid in reducing the effort required to lift, carry, dig, or cut. That reduction in effort can make a difference. Reducing the load has a positive cumulative effect as the body does not have to work as hard. Employers and workers need to ensure that the proper tools and equipment are available and in good repair.

Work-rest Cycles (non-regulatory)

Depending on the amount of work being performed and the environment, workers in hot environments need to ensure they take their allotted times for lunches and breaks. Working through a scheduled lunch or break is counter intuitive. As mentioned above, taking a break resets (to an extent) the cumulative effects of heat in a workday. Employers need to highly encourage meal periods and breaks. A worker doesn’t have to take the entire meal period in one setting. Rather, in the summer months, breaking up the traditional one hour into smaller micro-breaks in the afternoon in cooled or shaded locations may in fact be more effective than sitting down for an hour. Obviously, eating the right amount of food and replenishing the body with fluids during those micro-break sessions is a must.

Education & Awareness

We can never the devalue the importance of education and awareness. This goes beyond the simple handout or training session. This means truth depth of knowledge and understanding. Workers should be able to recognize and articulate the signs and symptoms of heat illness: confusion, loss of coordination, hot dry skin, profuse sweating, elevated core body temperature, throbbing headache, rapid heartbeat, dizziness, nausea, vomiting, muscle cramps in the abdomen, arms, and/or legs. Protocols should include finding shade, water, and cool zones if signs and symptoms being to manifest. Workers and employers should establish there are no barriers or repercussions for stopping work, notifying a supervisor, or calling emergency services if the worker beings to experience the effects of heat illness. You cannot be cautious enough. This all starts with providing quality training that is relevant and specific to the worker and the nature of the work. This ends with a clear understanding that worker safety is paramount and must be safeguarded no matter what.

Core Body Temperature

Controlling core body temperature is perhaps the most overlooked and underestimated opportunity in heat risk prevention. Until recently safety professionals have been programmed to focus on hydration, shading, and work-rest cycles. Most of the literature focuses on hats, clothing that wicks, and long sleeve shirts for reducing sun exposures. While those are effective measures, are they best materials in the heat transfer process? ?In today’s world we have the technology to aid the body in removing heat and assist with keeping the skin cool. For example, there are materials where the technology is woven into the fabrics. Simply wet them, wring them out, snap them and that activates their cooling properties. These fabrics have qualities that block up to 98% of harmful ultraviolet alpha and beta rays. There are four fundamental sources of heat that load onto the body: radiation, convection, conduction, and metabolic. Blocking radiation is essentially solar shielding. Wearing arm sleeves, neck towels, hats with napes made with these materials act as solar shields. Convection is the process of thermal energy being transferred by movement of heated fluids, such as liquid and air. Hot air moving onto hot skin is a micro-convection amplifier of heat transference.?Think of the letter or postal carrier that drives all day long with the door open. Hot moist air is moving over hot moist skin. Some of the fabrics available in the industrial setting are actually designed to cool the skin up to 30° degrees for up to two hours. Those fabrics woven into hats, sleeves, and neck wraps that are in direct contact with the head, neck, and arms cover a large surface area(s) were heat is known to accumulate in higher amounts can actually aid the body in the heat reduction process.

Artifacts and Elephants

The heat injury illness prevention equation is far from complete, but for the safety professional it is as foundational as Pythagoreans theorem. From this fundamental equation workers and employers can add variables that meet their very unique needs based on the nature of the work and their environments. However, the equation is rendered useless if some things are not done or met. I recommend staring with hazard analysis and risk assessment. The what, the where, the why, the likelihood, and the how bad need to be known before a solid prevention program can be developed. Second, think different. Most employers have heat prevention programs, but the question should be asked, can we do it better? Historical programs and processes may need to be updated or thrown out completely. Most programs are artifacts passed on from one management generation to next. Every few years, some words get changed and programs are re-packaged. But at the end of the day, they are the same old programs. Time for a change. Third, workers and employers need to address the taboo topics. Obesity is one such topic no one wants to address. I can see why as obesity has been anchored to bullying. Too many people have suffered at the hands of a bully over this issue. As a result people tend to shy away from it. But it’s the elephant in the room. Obesity is a serious health issue that impacts millions of people every day. Depression, anxiety, eating disorders, diabetes, and the like are linked with and to obesity. First and foremost, obesity is not an indictment. It’s a serious issue with devastating physical and psychological consequences. We often overlook the damaging inner dialogs people have with themselves. With education, kind consideration, and encouragement we can help people take those first steps on the path to reclaim their physical and mental health. Employers can assist with that journey by offering resources and education for employees. Most adults understand facts and if those facts are offered in a dignified manner adults will respond. Finally, heat prevention must be a team sport. Everyone in the organization must rally around heat prevention. All modes of communication must have heat prevention threads woven in. Meetings, work sessions, on-site visits, and on-the-job-training should have elements of the equation present.

Shift the Mindset

I had the recent opportunity spend some time with a CEO of one such company that manufactures heat gear. The takeaways were invaluable. Here are some of the takeaways; Industry has been slow to change the way it thinks about work and the workers who do the work. We, as safety professionals and business leaders must accept once and for all workers are industrials athletes not just employees. I believe most see that term, industrial athlete, and think of it more in the context of a buzz word. The reality is workers are no different than the athletes we see on television. Merriam-Webster defines athlete as, “a person who is trained or skilled in exercises, sports, or games requiring physical strength, agility, or stamina.” That definition works for people in warehousing, courier, construction, roofing, lawn and garden, and the like. What’s interesting is that industrial athlete is not word listed in Merriam-Webster’s dictionary. Therefore, I will take the liberty to define it: Industrial Athlete: a person who is trained or skilled in a work environment requiring physical strength, endurance, agility, dexterity, or stamina.”

Professional athletes are not managed, they are coached. The coaches’ development of the athlete is total and in perpetuity. Coaches train, practice, review performance, provide very honest feedback, challenge, encourage, support, set high standards, enforce high standards, and celebrate successes with their athletes in a continuous cycle.

Most athletes perform in the team setting and understand their individual role is crucial to the team’s success. Paul said it best to illustrate this point. “Now the body is not made up of one part but many (parts)…the foot should (not) say, ‘Because I am not a hand, I do not belong to the body’…On the contrary, those parts of the body that seem to be weaker are indispensable…if one part suffers, every part suffers, if one part is honored, every part rejoices with it.” As it goes with the team concept. Workers and employers are industrial athletes and coaches

In the end, heat is here to stay, and our industrial athletes are out there. Apply the equation and build on it as needed. Lean into technologies that aid in the body cooling process. If the program is old and not effective, then have the courageous self-leadership to throw it and start anew. Tackle the tough issues while being respectful of the people’s right to dignity and medical privacy. Model the behavior you expect your industrial athlete to exhibit. It should be our MISSION to provide the training, tools, and technologies to help Recharge our industrial athletes. They are valuable members of the team.?