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					Heat Illness Prevention
Title 8 Section 3395

Cal/OSHA Consultation Service 2008

Heat Illness Prevention
“Safety Basics”
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POTABLE DRINKING WATER
SHADE ALLOWING THE BODY TO COOL PREVENTATIVE RECOVERY PERIODS

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EMPLOYEE/SUPERVISOR TRAINING
WRITTEN PROCEDURES

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25 Serious Heat-Related Illnesses
May – November 2005

Enforcement Experience

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Agriculture 38% Construction 29% Service 12.5% Transportation 12.5% Public Safety 8%

What was discovered…
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68% of employees spoke Spanish

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Ages 17 to 76 yrs
84% of cases involved outdoor work

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92% of work was moderate  strenuous
46% of cases happened the 1st day on the job

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36% required hospitalization for more than 24hrs
54% of cases resulted in death of the employees

Environmental & Physiological Factors
Average
Ambient air temperature 96º F (75 - 116º F)

Humidity 29% (12% - 55%)
Wind speed 7mph Core body temperature 104º F (98 - 108º F)

Worksite Conditions
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Potable water present - 100% of cases Shade available - 77% of cases

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80% of employers had a written IIPP
20% had written Heat Illness Prevention Policy 36% had an Emergency Action Plan

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Worksite Conditions
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Heat Wave - a sudden and temporary rise of temperature above the seasonal average for a particular region, which last for a prolonged period of time

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Greatly increases the risk of heat illnesses

Heat Wave Impact
Temps/Day/Date/Cases
9 8 7 6 5 4 3 2 1 0 115 110 105 100 95 90 85 80
Da 16 te -J 17 u l -J 18 u l -J 19 u l -J 20 u l -J 21 u l -J 22 u l -J 23 u l -J 24 u l -J 25 u l -J 26 u l -J 27 u l -J 28 u l -J ul
Sun Sat Tue

Mon

# Reported Temp Kern Co

Historical Temp from UC IPM CIMIS

Note: Direct Relationship Between Temps and Number of Reported Cases 84% of the Cases Occurred During the July 2006 Heat Wave

Worksite Conditions
Heat Illness Prevention During Heat Waves
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Take Extra Measures - More Vigilance
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Supervisors/employees watch each other very closely & provide more frequent feedback Avoid working alone - “buddy system” Designate person - closely monitor/report employees conditions Account for employee whereabouts throughout the work shift and end of the day

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Worksite Conditions
Heat Illness Prevention During Heat Waves
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Take Extra Measures - More Water
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Employees should drink small quantities of water more frequently before, during and after work Effective replenishment of extra supplies of water Encourage employees to consult with their doctor on salt/mineral replacement

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Worksite Conditions
Heat Illness Prevention During Heat Waves
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Take Extra Measures - More Cooling
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Use other cooling measures in addition to shade Spraying body with water/wiping with wet towels Additional/longer breaks in the shade

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Worksite Conditions
Heat Illness Prevention During Heat Waves
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Take Extra Measures - Change Schedule
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Start work earlier or later in the evening Split-up work shifts - avoid working in hotter parts of the day Cut work shifts short or stop work

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Worksite Conditions
Heat Illness Prevention During Heat Waves

 Take Extra Measures - Change Meals
 Encourage employees to:
Eat smaller/more frequent meals ( less body heat during digestion than with big meals) Choose foods with higher water content (for example, fruits, vegetables, salads)

Worksite Conditions
Heat Illness Prevention During Heat Waves
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Acclimatization Warning
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Even employees previously fully acclimatized are at risk for heat illness
Body needs time to adjust to sudden, abnormally high temperatures or other extreme conditions

Heat Illness Prevention
3395(a) Scope and Application

Applies to the control of risk of occurrence of heat illness in all outdoor places of employment Does not exclude other Title 8 requirements, such as, IIPP, drinking water, first aid

3395(b) Definitions
“ 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.

3395(b) Definitions
“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.

“Acclimatization”
A 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 4 - 14 days of regular work for at least 2 hours per day in the heat.

3395(b) Definitions
"Shade" means blockage of direct sunlight. Canopies,
umbrellas and other temporary structures or devices may be used to provide shade. 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.

"Preventative Recovery Period“
means a period of time to recover from the heat in order to prevent heat illness.

3395(c) Provision of Water

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Sufficient amounts of cool water available at all times w/at least one quart per employee per hour for the entire shift
Easy access to clean and cool water encourages frequent drinking Keep the water replenished

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3395(d) Access to shade
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Preventative Recovery Period (PRP) is necessary if an employee is
suffering from heat illness or believes that a rest break is needed to recover from the heat

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Employees must have access to an area with shade that is either open to the air or provided with ventilation or cooling for a period of no less than 5 minutes

3395(d) Access to shade
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Access to shade is permitted at all times Non agricultural employers are permitted cooling measures other than shade if alternate means are proven as effective as shade in cooling the body

3395(e) Training
Recognition Procedures

of Environmental & Personal Risk Factors

for Complying with the Regulations

Importance
Importance Recognition

of Frequent Consumption of Water
of Acclimatization to Working Conditions of Signs/Symptoms of Heat Illnesses

Importance
Procedures Procedures Means

of Reporting Signs/Symptoms to Supervisor
to Follow When Heat Illness is Reported to Contact Medical Services

& Methods Available to Transport Ill Workers Procedure to Ensure Clear/Concise Directions are Given to Emergency Medical Responders to Locate the Worksite

Employee Training
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The environmental and personal risk factors for heat illness Importance of frequent consumptions of small quantities of water Importance of acclimatization Different types of heat illness, common signs and symptoms

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Employee Training
Importance of immediately reporting signs/symptoms of heat illness to supervisor Procedures for responding to possible heat illness
Procedures for contacting and directing emergency medical services to the worksite

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Section 3395(e)(1) Employee Training
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Procedures to follow when contacting emergency medical services and if necessary transporting employees Employers procedures that ensure clear and precise directions to the work site will be provided to emergency medical service providers.

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3395(e)(2) Supervisor Training

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Same information required under employee training PLUS
Procedures to follow to implement the applicable provisions of the standard Procedures to follow when an employee exhibits symptoms consistent with heat illness, including emergency response

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Impact of Supervisor Training on the Outcome of Heat Illness
Supervisor Training Conducted in Cases with Heat Related Fatality?
Percent

100 50 0 37% Trained 63% Not Trained

2006 Data

For Non-Fatal Heat Illnesses, Supervisor Trained on Heat Illness Prevention: Yes (67%) and No (33%)

Employer’s Written Procedures
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Written policy addresses controlling the risks of heat illness and includes all the elements in Section 3395 Policy and procedures can be integrated within the IIPP Training provided to all employees to recognize heat illness hazards before starting to work outdoors Procedures must be made available to representatives of Cal/OSHA upon request

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ADDITIONAL GUIDANCE

Internet Resources – Cal/OSHA & NIOSH
http://www.dir.ca.gov/DOSH/HeatIllnessInfo.html
http://www.cdc.gov/niosh/topics/heatstress/