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Beating the Heat: A Refresher on the Dangers of Heat Illness

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Summer can be both a blessing and a curse for the construction industry. The appeal of summer’s extended daylight hours is overshadowed by extreme heat and humidity—and, the dangers of heat stress and heat-related illness. 

Protecting construction crews (and potentially saving lives) from heat illness starts with safety officers and project managers taking a proactive approach. Workers also need an annual refresher on the signs and symptoms of heat exhaustion and heat stroke, and what to do if someone on the team starts to feel sick. 

“Folks tend to get complacent,” says Kathi Dobson, safety director at Alberici Constructors Inc. in St. Louis and chair of the National Association of Women in Construction-OSHA Alliance. 

“If they never had any kind of heat stress, they might think they’re immune to heat exposure or stress. You really have to take a look at the workforce and remind them that you’re exposed to the heat. There’s sun. There’s not a lot of wind. The humidity is high. And, you’re working outside.”

Dobson, also a registered nurse and certified safety professional, says the issue of heat illness is huge in the construction industry. 

“At some time in this year, almost everyone in the country is going to have a heat wave and unseasonably warm weather,” she says. “And, I think that not every company and not every project manager really plans for what to do.”

Recognizing the Heat Illness 

The U.S. Occupational Safety and Health Administration has an ongoing heat safety campaign aimed at protecting outdoor workers. Anyone working outside, exposed to the heat, is at risk for heat illness. 

When working in a hot environment, the body has to maintain a stable internal temperature and get rid of excess heat through circulating blood to the skin and sweating, according to OSHA. 

Cooling off is difficult when the outside air temperature is close to or warmer than the body’s normal temperature. Blood circulated to the skin cannot lose its heat, leaving sweating as the main way to cool off. But, sweating is only effective if the humidity level is low enough to allow for evaporation, and if lost fluids and salts are replaced. 

The body stores excess heat that it can’t get rid of, increasing the core temperature and heart rate. This can result in loss of concentration, sickness, and fainting. Signs that someone is experiencing heat exhaustion or heat stroke include: 

  • Dizziness
  • Headache
  • Weakness
  • Cramps
  • Nausea
  • Vomiting
  • Fast heart beat
  • Red, hot, dry skin
  • High temperature 
  • Confusion
  • Convulsions
  • Fainting 

Dobson says people often react differently to heat. In her experience, she says headaches, nausea, and vomiting are the most commonly cited symptoms. 

She also explains that some people are more at risk than others. They include people new to working outdoors, older workers, those who are overweight, or have pre-existing conditions, like diabetes, or respiratory, cardiac, or endocrine conditions.  

A general rule is to seek medical attention if anyone starts to feel sick on the jobsite. Dobson urges workers to keep an eye on one another and trust someone when they say they don’t feel well. 

“Get him up and get him evaluated, because unless you're a medical doctor, you have no way to check his internal temperature,” she says. 

Reporting Instances of Illness

According to OSHA, in 2014, more than 2,600 outdoor workers suffered from heat illness, and 18 died from heat stroke related to the job. 

Dobson says she thinks those numbers are probably low, especially considering the millions of construction workers in the country. But, she didn’t have construction-industry specific heat illness data. It all depends on the severity of cases, and how companies categorize and report instances of heat illness, she explains. 

An instance of someone not feeling well, but after a rest and drinking some water, they feel better and go back to work wouldn’t necessarily be reported. However, any instance requiring a hospital stay or a lengthy time away from work must be recorded and reported. 

OSHA law requires employers that expose workers to high temperatures create a heat illness prevention program that includes: 

  • Providing workers with water, rest, and shade
  • Allowing workers to gradually increase workloads and take frequent breaks to build tolerance to working in the heat
  • Planning for emergencies 
  • Training workers on prevention
  • Monitoring workers for signs of illness

Planning for Prevention 

Dobson emphasizes two aspects in preventing heat illness: creating a plan to work in the heat and educating workers on the signs and symptoms of heat illness. 

On the planning side, this may including adjusting work schedules to allow for more breaks during hot weather and adding extra staff to rotate during break time so there’s no lag in work. 

Setting up tents or canopies as cooling stations gives workers a place to rest and recharge. Mist fans are another element that can help crews cool off. Having plenty of water available and accessible on the jobsite is also essential. OSHA recommends that workers drink water every 15 minutes. 

Allocating time and resources to protect workers from the heat should be part of the bidding and scheduling process of any project that will run through the summer months, Dobson suggests. 

“The biggest thing that we fail to do is we don’t think about it,” she says. “When we bid a job, we know we need small tools and what those tools are going to be, and you need so many nuts and bolts to make connections on the structural steel. You know that if you're going to have 50 guys, you need 50 hard hats.” 

Heat safety should be just as important in the estimating and bid process, she says. 

Acclimatization, or building a tolerance to heat gradually, is also important in heat illness prevention. But, the tight schedules of most construction projects don’t always allow for it. 

“We don’t have the opportunity to give people a chance to get used to the hot weather,” Dobson explains. “This is a real challenge. You play on a tightrope when you're working with people, because you don’t really know.”


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