Heat Illness and Prevention Program by liaoqinmei

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									   Heat Illness Prevention Program (HIPP)


 Heat Illness Prevention Program
                 (HIPP)




               Insert
Department/Division/Bureau Name
              March, 2011
                       Heat Illness Prevention Program (HIPP)



                                      Table of Contents




Subject                                                                                                        Page
  I.   Purpose and Scope ....................................................................................... 3
 II.   Responsibilities ............................................................................................... 4
III.   Compliance ..................................................................................................... 5-7
IV.    Training ........................................................................................................... 8-12




Appendix
   A.    Heat Illness Prevention Standard
   B.    Heat Index
   C.    Water Needed Daily - worksheet
   D.    Environmental and Personal Risk Factor Definitions
   E.    Heat Related Illness, Symptoms and First Aid
   F.    Training Sign in Sheet
   G.    Emergency Response Procedures – POSTED AT WORKSITE
   H.    Resources




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                Heat Illness Prevention Program (HIPP)

I. Purpose

The (Insert Department/Division/Bureau name here) considers the safety and
health of its employees to be one of its top priorities. This program is intended to
serve as a guideline for employees to protect themselves against the effects of
heat illness and to meet the requirements of Title 8 California Code of Regulation
Section 3395 (T8 CCR 3395). See Appendix A for a copy of this Standard.

Scope
Heat illness is a serious medical condition resulting from the body’s inability to
cope with heat and to cool itself. The effect of heat illness can range from
sunburn to heat exhaustion and heat stroke. The hot temperatures that Los
Angeles experiences throughout the year make it imperative that all employees
affected are provided with the appropriate materials and training needed to keep
themselves safe. The Heat Illness Prevention Program (HIPP) is applicable to all
employees who work outdoors. This includes, but is not limited to, the following
divisions/job classifications: (List below)




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                 Heat Illness Prevention Program (HIPP)


II. Responsibilities
General Manager, Assistant General Managers, and Division Managers
Responsibilities are consistent with those outlined in the Injury and Illness
Prevention Program (IIPP).

Supervisors
In addition to the responsibilities listed in the IIPP, supervisors are responsible
for:
      Learning and following this Heat Illness Prevention Program.
      Providing training to their employees on how to prevent and treat heat
         illness. (See Section III for more details.)
      Providing potable drinking water and a shaded break area for all
         employees covered by the Heat Illness Prevention Program.
      Checking the temperature and humidity forecast before each shift.
      Knowing and being able to recognize the signs and symptoms of heat
         illness.
      Knowing the first aid procedures needed to treat the various forms and
         stages of heat illness.
      Posting HIPP Emergency Response Procedures (See Appendix G).
      Contacting emergency services and accurately reporting the work
         location to 911 when needed.

Employees
In addition to the responsibilities listed in the IIPP, employees are responsible for:

        Familiarizing themselves with and following the Heat Illness Prevention
         Program.
        Knowing and being able to recognize the signs and symptoms of heat
         illness.
        Knowing the first aid procedures needed to treat the various forms and
         stages of heat illness.
        Frequently consuming the provided drinking water throughout the work
         day.
        Taking a 5-minute break in an adequately shaded area when a
         preventative recovery period is needed.
        Contacting emergency services and accurately reporting the work
         location to 911 when needed. (See Appendix G).




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                Heat Illness Prevention Program (HIPP)



III. Compliance
Each (Insert Department/Division/Bureau name here) employee exposed to
the environmental risk factors of heat illness will be included in this program. This
means that they will be provided with an adequate water supply, shade for
recovery periods, and heat illness prevention/treatment training.

To ensure all employees comply with (Insert Department/Division/Bureau
name here) rules and maintain a safe workplace, the compliance system
includes:

Identifying weather conditions in which the program will take effect:

        Check heat index before beginning work (See Appendix B). If a heat
         advisory is released or the heat index is in the extreme caution (yellow),
         danger (light red) or extreme danger (dark red) the HIPP should be
         implemented.


Providing water and shade for employees:

Water:
     Ensure all employees working outdoors have access to potable drinking
       water. (Insert Department/Division/Bureau name here) will set aside
       funds for the purchase of water in locations where it is not plumbed or
       otherwise continuously supplied.
     Each applicable location will be provided with one quart of water per
       person per hour. (See Appendix C for worksheet.)
     Each applicable location will determine how water will be distributed to
       employees, (e.g. water coolers or water bottles).
     Water should be kept out of direct sunlight to remain as cool as possible.

To ensure access to sufficient quantities of potable drinking water, the following
steps will be taken. (outline steps here)




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               Heat Illness Prevention Program (HIPP)


Shade:
     Shade is defined as the blockage of direct sunlight; some sources of
       shade may include trees, canopies or buildings.
     All employees will be provided with a shaded area, or other cooling
       methods that are at least as effective, for their rest/recovery breaks.
     Shade is not adequate when heat in the area of shade does not allow
       the body to cool. Examples of inadequate places to seek shade are cars,
       parking booths (unless air conditioned), and heat generating machinery.
     Employees shall be allowed and encouraged to take a cool-down rest in
       the shade for a period of no less than five minutes at a time when they
       feel the need to do so to protect themselves from overheating. Such
       access to shade shall be permitted at all times.


To ensure access to shade at all time, the following steps will be taken:

(outline steps here)




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                Heat Illness Prevention Program (HIPP)


Training employees on how to identify and respond to heat illness:

        (Insert Department/Division/Bureau name here) will provide all
         employees subject to this standard with heat illness prevention training
         prior to beginning work that should reasonably be anticipated to result in
         exposure to the risk of heat illness.
        All training will cover the topics listed in section four of this program.
        Supervisors shall be trained in subsection (f)(2)(A) through (D) of Title 8
         CCR Section 3395 in addition to the topics listed in section four of this
         program.




To ensure employees and supervisors are trained, the following steps will be
taken:


(outline steps here)




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                 Heat Illness Prevention Program (HIPP)

IV. Training

Training provided by (Insert Name here) will cover the following topics:
       A. Environmental and personal risk factors.
       B. The procedures for complying with requirements of Title 8 California
          Code of Regulations Section 3395.
       C. The importance of water consumption.
       D. Acclimatization.
       E. The different types, signs and symptoms of heat illness.
       F. Reporting symptoms or signs of heat illness in themselves or in co-
          workers.
       G. Procedures for responding to symptoms of possible heat illness.
       H. Procedures for contacting emergency medical services.
       I. Procedures for ensuring that, in the event of an emergency, clear and
          precise directions to work site can and will be provided to emergency
          responders.

A. Environmental and personal risk factors

Environmental risk factors for heat illness are “working conditions that create the
possibility that heat illness could occur.” These risk factors include, but are not
limited to, the following:

       Air temperature
       Humidity
       Air movement
       Work severity and duration
       Personal Protective Equipment (PPE)

Personal risk factors for heat illness include but are not limited to the following:

       Age
       Health
       Water consumption
       Consumption of diuretics
       Degree of acclimatization
       Use of prescription and non-prescription medications

       **Definitions of the above risk factors are located in Appendix D **

B. Procedures for complying

In order to comply with the requirements set forth by the Title 8 California Code
of Regulations Section 3395, Insert Name here will do the following:


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                Heat Illness Prevention Program (HIPP)


      Provide all employees and supervisors with the training required by T8
       CCR 3395 subsection (f).
      Provide fresh water and shade for each employee.
      Develop and implement written procedures for complying with the heat
       illness prevention standard.
      All employees will be trained prior to working outdoors.
      When possible, working hours will be modified to work during the cooler
       hours of the day.
      When a modified or shorter work-shift is not possible, more water and rest
       breaks will be provided.
      Supervisors will stay alert to the presence of heat related symptoms.

C. Consumption of water
It is important that employees do not rely on thirst to prompt them to drink water.
Once a person begins to feel thirst, the body has already lost a significant
amount of water. During heavy physical activity an employee may need to drink
8-12 oz. of water every 20 minutes in order to prevent dehydration and heat
illness.

Employees are to avoid drinks with excessive amounts of sugar and
carbohydrates, as these ingredients may cause the employee to feel full or even
sick. Employees should come to work well hydrated and should take 5-minute
recovery periods to allow the body to cool off throughout the workday. If possible,
keep water out of direct sunlight and encourage employees to frequently drink
small quantities of water when the work environment is hot and employees are
likely to sweat more than usual.

D. Acclimatization
When supervisors and employees are exposed to the environmental and
personal risk factors of heat illness, they should take the proper precautions. Use
of acclimatization, the gradual adaptation of the body to work in the heat, can
help minimize an employee’s chances of falling ill. Most people become
acclimated to significant changes in temperature by progressively increasing their
workload over a period of four to ten days. The human body needs time to adjust
to working in hot and humid conditions.

Acclimatization is important for employees that are: returning to work after a
prolonged absence, returning to work after being off sick, moving from a cooler
climate to a hotter climate, or are in an area experiencing a heat wave bringing
higher temperatures/ humidity levels.

E. The different types, signs and symptoms of heat illness
There are five different types of heat illness that employees and supervisors
need to be aware of and be able to recognize while working. It is important that
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               Heat Illness Prevention Program (HIPP)

all employees working in the sun remain aware of how their bodies are handling
working under the various environmental and personal risk factors. They should
also be aware of how their co-workers are handling working under extreme
conditions.
     Sunburn
     Heat Rash
     Heat Cramps
     Heat Exhaustion
     Heatstroke (or sunstroke)

**For further information concerning these heat illnesses please see
Appendix E. **

F. Reporting the symptoms or signs of heat illness

If employees are experiencing any of the heat illness signs or symptoms they
should:

   1. Immediately report these signs or symptoms to their immediate
      supervisors.
   2. If the victim’s symptoms indicate sunburn, heat rash, heat cramps or heat
      exhaustion the supervisor should follow the first aid procedures listed in
      section G below.
   3. If the victim’s symptoms indicate heatstroke the supervisor should follow
      the directions in section G and immediately seek medical attention.

G. Procedures for responding to heat illness symptoms
   1. When a victim experiences symptoms of heat illness the supervisor must
      be immediately notified.
   2. Commence first aid treatment and contact emergency services if needed.

      Sunburn
      Symptoms of sunburn usually include redness and pain. In severe cases
      there may be swelling of skin, blisters, fever and headaches.

            Use ointment for mild cases of blisters.
            If the blisters break one should apply dry sterile dressing.
            A physician should be seen for extensive cases.

      Heat Rash
      This form of heat illness is one of the most common problems in hot work
      environments. Symptoms generally include red clusters of pimples or
      small blisters on the neck and upper chest.

            Keep the affected area dry.
            Avoid using ointments or creams- they may make the condition
             worse.
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            Heat Illness Prevention Program (HIPP)


   Heat Cramps
   The victim will feel muscle pains or spasms, usually in the abdomen, arms
   or legs.

         Stop all activity and sit in an air-conditioned or shaded area.
         Drink cool water, clear juices or sports drinks.
         Seek medical attention if cramps continue.

   Heat Exhaustion
   Symptoms of heat exhaustion may include heavy sweating and weakness,
   a fast and weak pulse rate, nausea, fainting or vomiting.

         Stop all activity and get into an air-conditioned or shaded area.
         Lie down and loosen clothing.
         Drink cool, not iced, water or sports drinks.
         Cool the person by spraying or sponging him or her with cool water
          and fanning.
         Monitor the person carefully. Heat exhaustion can quickly become
          heatstroke. If fever greater than 102 F, fainting, confusion or
          seizures occur, call for emergency medical assistance.

   Heatstroke or Sunstroke
   Symptoms of heatstroke may include high body temperature (106 F or
   higher), hot dry skin, unconsciousness or convulsions.

         Stop all activity and get victim into an air-conditioned or shaded
          area.
         Call for emergency medical assistance.
         Do not give anything by mouth (even water).
         Cool the person by spraying or sponging him or her with cool water
          and fanning.

3. Once the employee has been treated, the supervisor should conduct an
   emergency refresher on Heat Illness Prevention for all employees on site.
4. The supervisor should have employees fill out a sign in sheet for training
   (see example in Appendix F).
5. The supervisor must attach a summary of what was said along with any
   handouts that were passed out.
6. If the victim is hospitalized the supervisor must immediately notify Cal-
   OSHA. http://www.dir.ca.gov/asp/DoshZipSearch.html




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                 Heat Illness Prevention Program (HIPP)




H. Contacting emergency services
All supervisors are responsible for filling in all the site-specific information on the
Emergency Response Procedures form, located in Appendix G.

Under item one of the Emergency Response Procedures form, supervisors are
responsible for filling in the phone number employees must use to contact
emergency services. Each job site determines this number.

I. Clear and precise directions
Under item two of the Emergency Response Procedures form (Appendix G),
supervisors are responsible for filling in the full address and contact number for
the work site. Employees will be using this information during an emergency so it
is important to be as specific as possible. In the “Special Instructions” section the
supervisor must write down any instructions emergency services may need in
order to reach the victim/worksite. It is important that the supervisor gives special
instructions that are specific to the work location. If there is a section in item two
that does not apply to your workplace please write N/A in the blank spaces
provided.



   *** Once the Emergency Response Procedures form is completed
   please post the form in a location that is accessible to all employees. ***




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               Heat Illness Prevention Program (HIPP)

                              HIPP APPENDIX A
Subchapter 7. General Industry Safety Orders
Group 2. Safe Practices and Personal Protection
Article 10. Personal Safety Devices and Safeguards
§3395. Heat Illness Prevention

    Heat Illness Info



(a) Scope and Application.

   (1) This standard applies to all outdoor places of employment.

   Exception: If an industry is not listed in subsection (a)(2), employers in that
   industry are not required to comply with subsection (e), High-heat procedures.

   (2) List of industries subject to all provisions of this standard, including
   subsection (e):

       (A) Agriculture

       (B) Construction

       (C) Landscaping

       (D) Oil and gas extraction

       (E) Transportation or delivery of agricultural products, construction materials
       or other heavy materials (e.g. furniture, lumber, freight, cargo, cabinets,
       industrial or commercial materials), except for employment that consists of
       operating an air-conditioned vehicle and does not include loading or
       unloading.

   (3) This section applies to the control of risk of occurrence of heat illness. This is
   not intended to exclude the application of other sections of Title 8, including, but
   not necessarily limited to, sections 1512, 1524, 3203, 3363, 3400, 3439, 3457,
   6251, 6512, 6969, 6975, 8420 and 8602(e).

   Note No. 1: The measures required here may be integrated into the employer's
   written Injury and Illness Program required by section 3203, or maintained in a
   separate document. The measures required here may be integrated into the
   employer's written Injury and Illness Program required by section 3203, or
   maintained in a separate document.

   Note No. 2: This standard is enforceable by the Division of Occupational Safety
   and Health pursuant to Labor Code sections 6308 and 6317 and any other
   statutes conferring enforcement powers upon the Division. It is a violation of
   Labor Code sections 6310, 6311, and 6312 to discharge or discriminate in any
   other manner against employees for exercising their rights under this or any
   other provision offering occupational safety and health protection to employees.
   This standard is enforceable by the Division of Occupational Safety and Health
   pursuant to Labor Code sections 6308 and 6317 and any other statutes
   conferring enforcement powers upon the Division. It is a violation of Labor Code
   sections 6310, 6311, and 6312 to discharge or discriminate in any other manner
   against employees for exercising their rights under this or any other provision
   offering occupational safety and health protection to employees.
                   Heat Illness Prevention Program (HIPP)

(b) Definitions.

“Acclimatization” means temporary adaptation of the body to work in the heat that
occurs gradually when a person is exposed to it. Acclimatization peaks in most
people within four to fourteen days of regular work for at least two hours per day in
the heat.

“Heat Illness” means a serious medical condition resulting from the body's inability
to cope with a particular heat load, and includes heat cramps, heat exhaustion, heat
syncope and heat stroke.

“Environmental risk factors for heat illness” means working conditions that create
the possibility that heat illness could occur, including air temperature, relative
humidity, radiant heat from the sun and other sources, conductive heat sources such
as the ground, air movement, workload severity and duration, protective clothing
and personal protective equipment worn by employees.

“Landscaping” means providing landscape care and maintenance services and/or
installing trees, shrubs, plants, lawns, or gardens, or providing these services in
conjunction with the design of landscape plans and/or the construction (i.e.,
installation) of walkways, retaining walls, decks, fences, ponds, and similar
structures, except for employment by an employer who operates a fixed
establishment where the work is to be performed and where drinking water is
plumbed.

“Oil and gas extraction” means operating and/or developing oil and gas field
properties, exploring for crude petroleum or natural gas, mining or extracting of oil
or gas or recovering liquid hydrocarbons from oil or gas field gases.

“Personal risk factors for heat illness” means factors such as an individual's age,
degree of acclimatization, health, water consumption, alcohol consumption, caffeine
consumption, and use of prescription medications that affect the body's water
retention or other physiological responses to heat.

“Shade” means blockage of direct sunlight. One indicator that blockage is sufficient
is when objects do not cast a shadow in the area of blocked sunlight. Shade is not
adequate when heat in the area of shade defeats the purpose of shade, which is to
allow the body to cool. For example, a car sitting in the sun does not provide
acceptable shade to a person inside it, unless the car is running with air conditioning.
Shade may be provided by any natural or artificial means that does not expose
employees to unsafe or unhealthy conditions.

“Temperature” means the dry bulb temperature in degrees Fahrenheit obtainable by
using a thermometer to measure the outdoor temperature in an area where there is
no shade. While the temperature measurement must be taken in an area with full
sunlight, the bulb or sensor of the thermometer should be shielded while taking the
measurement, e.g., with the hand or some other object, from direct contact by
sunlight.

(c) Provision of water. Employees shall have access to potable drinking water
meeting the requirements of Sections 1524, 3363, and 3457, as applicable. Where
drinking water is not plumbed or otherwise continuously supplied, it shall be
provided in sufficient quantity at the beginning of the work shift to provide one quart
per employee per hour for drinking for the entire shift. Employers may begin the
shift with smaller quantities of water if they have effective procedures for
replenishment during the shift as needed to allow employees to drink one quart or
more per hour. The frequent drinking of water, as described in subsection (f)(1)(C),
shall be encouraged.
                Heat Illness Prevention Program (HIPP)


(d) Access to shade.

    (1) Shade required to be present when the temperature exceeds 85 degrees
    Fahrenheit. When the outdoor temperature in the work area exceeds 85 degrees
    Fahrenheit, the employer shall have and maintain one or more areas with shade
    at all times while employees are present that are either open to the air or
    provided with ventilation or cooling. The amount of shade present shall be at
    least enough to accommodate 25% of the employees on the shift at any time, so
    that they can sit in a normal posture fully in the shade without having to be in
    physical contact with each other. The shaded area shall be located as close as
    practicable to the areas where employees are working.

    (2) Shade required to be available when the temperature does not exceed 85
    degrees Fahrenheit. When the outdoor temperature in the work area does not
    exceed 85 degrees Fahrenheit employers shall either provide shade as per
    subsection (d)(1) or provide timely access to shade upon an employee's request.

    (3) Employees shall be allowed and encouraged to take a cool-down rest in the
    shade for a period of no less than five minutes at a time when they feel the need
    to do so to protect themselves from overheating. Such access to shade shall be
    permitted at all times.

    Exceptions to subsection (d):

    (1) Where the employer can demonstrate that it is infeasible or unsafe to have a
    shade structure, or otherwise to have shade present on a continuous basis, the
    employer may utilize alternative procedures for providing access to shade if the
    alternative procedures provide equivalent protection.

    (2) Except for employers in the agricultural industry, cooling measures other
    than shade (e.g., use of misting machines) may be provided in lieu of shade if
    the employer can demonstrate that these measures are at least as effective as
    shade in allowing employees to cool.

(e) High-heat procedures. The employer shall implement high-heat procedures when
the temperature equals or exceeds 95 degrees Fahrenheit. These procedures shall
include the following to the extent practicable:

    (1) Ensuring that effective communication by voice, observation, or electronic
    means is maintained so that employees at the work site can contact a supervisor
    when necessary. An electronic device, such as a cell phone or text-messaging
    device may be used for this purpose only if reception in the area is reliable.

    (2) Observing employees for alertness and signs or symptoms of heat illness.

    (3) Reminding employees throughout the work shift to drink plenty of water.

    (4) Close supervision of a new employee by a supervisor or designee for the first
    14 days of the employee's employment by the employer, unless the employee
    indicates at the time of hire that he or she has been doing similar outdoor work
    for at least 10 of the past 30 days for 4 or more hours per day.

(f) Training.

    (1) Employee training. Effective training in the following topics shall be provided
    to each supervisory and non-supervisory employee before the employee begins
            Heat Illness Prevention Program (HIPP)

work that should reasonably be anticipated to result in exposure to the risk of
heat illness:

   (A) The environmental and personal risk factors for heat illness, as well as
   the added burden of heat load on the body caused by exertion, clothing, and
   personal protective equipment.

   (B) The employer's procedures for complying with the requirements of this
   standard.

   (C) The importance of frequent consumption of small quantities of water, up
   to 4 cups per hour, when the work environment is hot and employees are
   likely to be sweating more than usual in the performance of their duties.

   (D) The importance of acclimatization.

   (E) The different types of heat illness and the common signs and symptoms
   of heat illness.

   (F) The importance to employees of immediately reporting to the employer,
   directly or through the employee's supervisor, symptoms or signs of heat
   illness in themselves, or in co-workers.

   (G) The employer's procedures for responding to symptoms of possible heat
   illness, including how emergency medical services will be provided should
   they become necessary.

   (H) The employer's procedures for contacting emergency medical services,
   and if necessary, for transporting employees to a point where they can be
   reached by an emergency medical service provider.

   (I) The employer's procedures for ensuring that, in the event of an
   emergency, clear and precise directions to the work site can and will be
   provided as needed to emergency responders. These procedures shall include
   designating a person to be available to ensure that emergency procedures
   are invoked when appropriate.

(2) Supervisor training. Prior to supervising employees performing work that
should reasonably be anticipated to result in exposure to the risk of heat illness
effective training on the following topics shall be provided to the supervisor:

   (A) The information required to be provided by section (f)(1) above.

   (B) The procedures the supervisor is to follow to implement the applicable
   provisions in this section.

   (C) The procedures the supervisor is to follow when an employee exhibits
   symptoms consistent with possible heat illness, including emergency
   response procedures.

   (D) How to monitor weather reports and how to respond to hot weather
   advisories.

(3) The employer's procedures for complying with each requirement of this
standard required by subsections (f)(1)(B), (G), (H), and (I) shall be in writing
and shall be made available to employees and to representatives of the Division
upon request.
               Heat Illness Prevention Program (HIPP)

 Note: Authority cited: Section 142.3, Labor Code. Reference: Section 142.3, Labor
Code.

                                     HISTORY

1. New section filed 8-22-2005 as an emergency; operative 8-22-2005 (Register
2005, No. 34). A Certificate of Compliance must be transmitted to OAL by 12-20-
2005 or emergency language will be repealed by operation of law on the following
day.

2. New section refiled 12-20-2005 as an emergency; operative 12-20-2005 (Register
2005, No. 51). A Certificate of Compliance must be transmitted to OAL by 4-19-2006
or emergency language will be repealed by operation of law on the following day.

3. New section refiled 4-19-2006 as an emergency; operative 4-19-2006 (Register
2006, No. 16). A Certificate of Compliance must be transmitted to OAL by 8-17-2006
or emergency language will be repealed by operation of law on the following day.

4. Certificate of Compliance as to 4-19-2006 order, including amendment of section
heading and section, transmitted to OAL 6-16-2006 and filed 7-27-2006 (Register
2006, No. 30).

5. Amendment filed 10-5-2010; operative 11-4-2010 (Register 2010, No. 41).
Heat Illness Prevention Program (HIPP)




          HIPP APPENDIX B

             Heat Index
               Heat Illness Prevention Program (HIPP)

                                APPENDIX C

                            Water Needed Daily


The Heat Illness prevention standard, Title 8, California Code of Regulations,
Section 3395, requires all employers with outdoor worksites to take 4 basic steps
to prevent heat illness:

   1. Provide heat illness prevention training to all employees, including
      supervisors.
   2. Provide access to shade for at least 5 minutes of rest when an employee
      believes he or she needs a preventative recovery period.
   3. Develop and implement written procedures for complying with the Heat
      Illness Prevention Standard.
   4. Provide enough fresh, cool water so that each employee can drink at least
      1 quart per hour and encourage them to do so.

The following calculations are being provided to help locations determine the
amount of water needed daily at each location. These calculations are based
on an 8-hour workday. The amount of water required increases for
employees who work 9 or 10-hour days.




                ____________ x          8 = _____________
                # of employees              # of quarts/day




               ____________ x 2 = ______________
                # of employees    # of gallons/day




Cal/OSHA data has revealed that a significant percentage of those who
succumbed to the heat suffered from dehydration even though drinking
water was available. Under extreme conditions employees can lose up to a
quart of water an hour through perspiration and may not feel thirsty until
they are already dehydrated. It is important that employees are provided
with water and also encouraged to drink an adequate
amount throughout the day.
                 Heat Illness Prevention Program (HIPP)

                               HIPP APPENDIX D

   Environmental and Personal Risk Factor Definitions


Air temperature/humidity
There is no absolute temperature cut off below which work in heat is not a risk.
With heavy work at high humidity sweat will not evaporate as quickly as is
needed to adequately cool the body’s temperature. At temperatures at or above
90F, especially with heavy work, heat risk reduction needs to be a major
concern.

Air movement
Convection is the process by which the body exchanges heat with the
surrounding air. The body gains heat from hot air and loses heat to cold air that
comes in contact with the skin. Convective heat exchange increases with
increasing air speed and increased differences between air and skin
temperature. If air movement is limited, the body’s ability to cool itself may be
affected.

Work severity and duration
In moderately hot environments, the body "goes to work" to get rid of excess heat
so it can maintain its normal body temperature. The heart rate increases to pump
more blood through outer body parts and skin so that excess heat is lost to the
environment, and sweating occurs. These changes impose additional demands
on the body. Changes in blood flow and excessive sweating reduce a person's
ability to do physical and mental work. Manual work produces additional
metabolic heat and adds to the body heat burden. When the environmental
temperature rises above 86°F, it may interfere with the performance of mental
tasks.

Protective equipment worn by employees
With heavy work, if employees are wearing protective clothing they could be at
risk. Employees wearing protective equipment, tight clothing and dark colors are
also at risk.

Personal risk factors for heat illness include but are not limited to the following:

Age
Old age and youth may impair the body’s ability to perspire and regulate its
temperature.

Health
People who are physically ill, especially with heart disease or high blood
pressure may be affected by extreme heat.
                   Heat Illness Prevention Program (HIPP)

Water consumption
Cal/OSHA data has revealed that a significant percentage of those who
succumbed to heat illness suffered from dehydration even though drinking water
was available. Under extreme conditions employees can lose up to a quart of
water an hour through perspiration and may not feel thirsty until they are already
dehydrated. It is important that employees are provided with water and also
encouraged to drink an adequate amount throughout the day.

Consumption of diuretics
Drinks such as coffee, tea, alcohol and soda deplete body fluid and can help
cause dehydration. Employees should avoid consuming these types of drinks
while working in warm environments.

Degree of acclimatization
Acclimatization is particularly important for employees returning to work after (1)
a prolonged absence, (2) recent illness, or (3) recently moving from a cool to hot
climate. For heavy work under hot conditions, a period of 4 to 10 days of
progressively increasing work time is recommended.

Use of prescription and non-prescription medications

           Medication type                                         How it affects your body
Anti-motion-sickness drugs that contain                       Inhibits sweating; and
                atropine                                      Creates cardiac disturbances.
                                                              Causes dehydration;
  Diuretics (medications that increase
                                                              Decreases cardiac output; and
               urination)
                                                              Inhibits sweating.
  Stomach (gastrointestinal) drugs that
                                                              Inhibits sweating.
  contain atropine (such as Donnatal)
                                                              Affects ability to recognize increases in
Tranquilizers and some over-the-counter
                                                               body temperature; and
              sleeping pills
                                                              Affect thirst thresholds.
                                                              Affects ability to recognize increases in
  Antidepressants and antipsychotics
                                                               body temperature; and
  (such as Prozac, Thorazine, Haldol)
                                                              Increases body temperature.
                                                              Constricts blood vessels;
Antihistamines (allergy medications such
                                                              Inhibits sweating; and
             as Benadryl)
                                                              Increases body heat.
 Heart (cardiovascular) drugs, including                      Decreases cardiac output and later
 beta blockers (such as Blocadren) and                         blood flow; and
        diuretics (such as Diuril)                            Causes dehydration.
                                                              Inhibits sweating; and
    Parkinson's disease medications
                                                              Creates cardiac disturbances.
     2007 Washington State Department of Labor and Industries. Division of Occupational Safety and Health
                 Heat Illness Prevention Program (HIPP)

                          HIPP APPENDIX E
             Heat Related Illness, Symptoms and First Aid

Always drink plenty of water and take frequent breaks when working or
playing in hot weather.

What are the different types of heat-related illnesses?
Heat           Symptoms                             First Aid
Disorder
Sunburn          -   Redness and pain                   Ointment for mild cases if blisters
                 -   In severe cases: swelling of skin, appear. If breaking occurs, apply dry
                     blisters, fever, and headaches     sterile dressing. A physician should
                                                        see serious, extensive cases.
Heat Rash        -   Red clusters of pimples or small Keep the affected area dry. Dusting
                     blisters on the neck and upper powder may be used to increase
                     chest, in the groin, under the comfort, but avoid using ointments or
                     breasts, and in elbow creases      creams – they keep the skin warm
                                                        and moist and may make the
                                                        condition worse.
Heat Cramps      -   Muscle pains or spasms usually in Stop all activity and sit in a cool place.
                     the abdomen, arms, or legs         Drink water, clear juices, or sports
                 -   Heavy sweating                     beverages such as Gatorade. Seek
                                                        medical attention if pain does not
                                                        subside in one hour.
Heat             -   Heavy sweating and weakness        Get out of the sun and into an air-
Exhaustion       -   Skin is cold, pale and/or clammy   conditioned environment. Lie down
                 -   Muscle cramps                      and loosen clothing. Drink cool, non-
                 -   Tiredness, weakness, dizziness, alcoholic beverages. Take a cool
                     headache                           shower, bath, or sponge bath. If
                 -   Fast and weak pulse rate           vomiting continues, seek immediate
                 -   Fast and shallow breathing         medical attention.
                 -   Nausea, fainting or vomiting
Heatstroke (or   -   High body temperature (106°F or Heatstroke is a severe medical
sunstroke)           higher)                            emergency.       Summon         medical
                 -   Hot dry skin (no sweating)         assistance or get the victim to a
                 -   Rapid and strong pulse             hospital immediately. Delay can be
                 -   May be extremely disoriented       fatal.
                 -   Possible unconsciousness           Move the victim to a cooler
                 -   Possible convulsions               environment.        Reduce          body
                                                        temperature with a cold bath or
                                                        sponging. Use extreme caution.
                                                        Remove clothing, use fans and air
                                                        conditioners. If temperature rises
                                                        again, repeat process. Do not give
                                                        anything by mouth (even water).
                 Heat Illness Prevention Program (HIPP)

Who's at Risk?
Anyone exposed to high temperatures for a sustained period of time is at risk for
a heat-related illness or death. The body normally cools itself by sweating. Under
some conditions, however, sweating just isn’t enough. In such cases, a person’s
body temperature rises rapidly. Very high body temperatures may damage the
brain or other vital organs. Several factors affect the body’s ability to cool itself
during extremely hot weather. When the humidity is high, sweat will not
evaporate as fast, preventing the body from releasing heat quickly. Other
conditions that impair the body's ability to regulate its temperature or that inhibit
perspiration include old age, youth (age 0-4), obesity, fever, dehydration, heart
disease, mental illness, poor circulation, sunburn, and prescription drug or
alcohol use.

How Can You Prevent Heat-Related Illness?
- Drink more fluids (nonalcoholic) regardless of your activity level. Don’t wait until
  you’re thirsty to drink. Warning: If your doctor generally limits the amount of fluid
  you drink or has you on water pills, ask him/her how much you should drink while
  the weather is hot.
- Limit liquids that contain caffeine, alcohol, or large amounts of sugar – these
  actually cause you to lose more body fluid. Also, avoid very cold drinks, because
  they can cause stomach cramps.
- Stay indoors and, if at all possible, stay in an air-conditioned place. If your home
  does not have air conditioning, go to the shopping mall or public library – even a
  few hours spent in air conditioning can help your body stay cooler when you go
  back into the heat. Call your local health department to see if heat-relief shelters
  are available in your area.
- Electric fans may provide comfort, but when the temperature is in the high 90s,
  fans will not prevent heat-related illnesses. Taking a cool shower or bath, or
  moving to an air-conditioned place is a much better way to cool off.
- Wear lightweight, light-colored, loose-fitting clothing.
- During heat waves, check on the elderly, disabled, and homebound people to
  ensure their safety. Never leave children in cars or similar enclosed spaces, and
  make sure they aren't able to lock themselves in an enclosed space such as a
  car trunk.
- NEVER leave anyone or an animal inside a vehicle without proper ventilation.

If you must be out in the heat:
- Limit your outdoor activity to morning and evening hours. Take cover during the
    sun's peak hours from noon to 3pm. Try to rest often in shady areas.
- Cut down on exercise. If you must exercise, drink two to four glasses of cool,
    nonalcoholic fluids each hour. A sports beverage can replace the salt and
    minerals you lose in sweat. Warning: If you are on a low-salt diet, talk with your
    doctor before drinking a sports beverage.
- Protect yourself from the sun by wearing a wide-brimmed hat (also keeps you
    cooler) and sunglasses and by putting on sunscreen of SPF 15 or higher (the
    most effective products say “broad spectrum” or “UVA/UVB protection” on their
    labels).
               Heat Illness Prevention Program (HIPP)

Disclaimer
These self-help measures are not a substitute for medical care but are
intended to help you recognize and respond promptly to warning signs of
trouble. Your best defense against heat-related illness is prevention.
Staying cool and making simple changes in your fluid intake, activities, and
clothing during hot weather can help you remain safe and healthy.

For more information:
1. Please look at http://www.osha.gov/SLTC/heatstress/
2. Talk to your supervisor or manager;
3. Contact City of LA Personnel Dept. Safety Engineer at 213 473-3392
              Heat Illness Prevention Program (HIPP)

                           HIPP APPENDIX F
                             Sign in Sheet

               Title: Heat Illness Prevention Training
Date: ______________             Length of Training__________

         Employee Name                   Initials           Date of
                                                          Completion




** Attach a short description of material covered along with any handouts
given to employees**
               Heat Illness Prevention Program (HIPP)

                             HIPP APPENDIX G

                    Emergency Response Procedures

If the first aid recommendations in Section G do not reduce the employee’s
symptoms, their condition becomes worse, or the employee exhibits signs of heat
exhaustion or heat stroke, use the following:

   1. Immediately call ___________________ for assistance.

   2. Give the address and, if needed, any special instructions on how to enter
      the work site.

      _________________________________
                   Address

      _________________________________
             City, State and Zip Code

      _________________________________
             Call Back Phone Number


      Special Instructions On How To Reach The Victim:

      ___________________________________________________________

      ___________________________________________________________

      ___________________________________________________________

      ___________________________________________________________


   3. If possible, send someone to flag down emergency services.

   4. If the victim is hospitalized overnight for anything other than observation
      the supervisor is required to contact Cal-OSHA to report the incident.
               Heat Illness Prevention Program (HIPP)


                              HIPP APPENDIX H

                                    Resources




Cal/OSHA
http://www.dir.ca.gov/DOSH/HeatIllnessInfo.html


National Weather Service
(Current temperature and humidity level depending location.)
http://weather.noaa.gov/weather/CA_cc_us.html


Canadian Center for Occupational Health and Safety
http://www.ccohs.ca/oshanswers/phys_agents/heat_health.html


Centers for Disease Control and Prevention
http://www.bt.cdc.gov/disasters/extremeheat/faq.asp


Fed/OSHA
http://www.osha.gov/dts/osta/otm/otm_iii/otm_iii_4.html

								
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