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Safety in the Heat Programme Summer 2012

Darren JoubertOccupational and Environmental HealthHealth Promotion and Surveillance Dept.

Health Authority – Abu Dhabi

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H.E. Zaid Al Siksek,HAAD CEO

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• What is the problem?• What is the HAAD safety in Heat programme?• How can it help?• What are the key messages and components of the

programme• How do you use the materials on-site?• How do you assess heat stress?• How do you get the materials?

What we will cover…

What is the problem?

Working in the Heat is a Significant Occupational Hazard in Abu Dhabi

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Heat Related Illness Cases treated in one Hospital Emergency Dept. (Survey 2007)

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec0

100

200

300

400

500

600

700

800

Heat Related Illness Cases

Count of Cases

3,017+ cases of heat-related illness seen at HCFs in Abu Dhabi Emirate, 2010

HEAT EXHAUSTION HEAT STROKE HEAT SYNCOPE PRICKLY HEAT TOTAL0

500

1000

1500

2000

2500

3000

3500

2025

122 88

829

3017

Heat Related Illness Cases

Heat-related illness, by medical condition

What happens when you are exposed to heat?

How do you heat up?

• Normal Body Metabolism• Work and Exercise• Environmental Heat Loss or

Gain

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Thermal Radiation60% heatexchange

Convection from airtemperature 12% of heatexchange

Conduction from hotsurfaces 3% of heatexchange

How do you cool down?

• Perspiration/Sweating and• Evaporation of sweat• Cooling is affected by:

– sweat rate– sweat volume– Evaporation– air movement– humidity

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What happens in a cool environment?

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What happens in a hot environment?

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DEHYDR

ATION

What happens when you get Dehydration?

Un-replaced sweat loss results in dehydration which means:

• there is less blood available to go to the skin and the ability to lose heat is lost• heart rates and blood pressure increase because of this smaller volume,

resulting in excessive fatigue• blood supply to the gut is reduced resulting in decreased fluid absorption• less blood is available to supply working muscles so less work can be performed• mental capacity is reduced due to decreased blood flow to the brain (increase

risk of accidents and injuries)

Electrolyte Loss - Sodium

• Sodium is the major electrolyte lost in sweat so needs to be replaced through diet and electrolyte drinks - NOT SALT TABLETS

• Sodium is essential for many body functions including the maintenance of fluid balance, regulation of blood pressure, and normal function of the nervous system.

• Too little sodium leads to hyponatremia which can be a severe condition and can be fatal.

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What is the Magic Number?

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370 CelsiusHeat GAIN Heat LOSS

• Sweat production and Evaporation

• Electrolyte loss/replacement

• Acclimatisation• Personal Factors –

age, medication, BMI, fitness,

• Air Temperature• Radiant Heat -

Sun• Humidity• Wind Speed• Workload• Clothing

What does the law say?

UAE Labour Law Ministerial Resolution

• Employers have a legal responsibility to protect the health of their workers as stipulated by the UAE Labour Law (Federal Law No. 8 of 1980).

• Follow the Ministry of Labour Ministerial Resolution for the midday break in summer:

15 June – 15 September 201212:30 pm – 3:00 pm

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Legal Responsibilities of Employers

• Work hours should no exceed 8 hours per day• Publish the daily schedule of work in Arabic and

languages the workers can understand• Provide Shaded rest areas (preferably air-conditioned)• Provide adequate drinking water and electrolyte

replacement (food or drinks)

• Fines and Penalties: – AED 15 000 for each case of breach– Downgrading of Company Category

• Heat exposure and heat stroke can be fatal if proper controls are not implemented.

EHSMS CoP and Technical Guideline

Abu Dhabi EHSMS RF ver. 2.0 – Feb 2012

Who does EHSMS regulations apply to?

• All employers in the Emirate of Abu Dhabi that

• Have employees working in high temperature environments including:– Outdoors in summer and– Other hot site operations (furnaces,

smelters, factories and other hot environments)

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Main Elements of the Code of Practice

• Training and Competency• Workers and new workers/visitors• Managers and Supervisors• First Aiders

• Roles and Responsibilities• Employers• Employees

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Heat Stress Programme Requirements

• Perform risk assessment• Implement acclimatisation programme• Assess environmental conditions (TWL index)• Communicate conditions to employees (e.g.:

flag system)• Provide water and electrolyte drinks• Provide appropriate PPE (drinking bottles)• Provide shade and cooling shelters• Schedule work in coolest part of the day/obey

midday break rule

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Heat Stress Programme Requirements..

• Provide pre-employment screening and medical clearance to identify chronic medical conditions (not visa screening)

• Conduct pre-employment training (inductions)• Implement Engineering controls to reduce exposure• Train and provide first aiders• Implement audit and inspection programme• Train all employees• Investigate and report heat illness

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Record Keeping for Heat Stress programme

Keep record of:• Heat stress programme initiatives and activities• Details of training and awareness activities and

messages communicated to employees• Details of heat stress related facilities, services

provided e.g.: first aid, shade, engineering controls used etc.

• Programme evaluation, stats, cost-benefit information etc.

• Heat stress related incidents e.g.: heat illness, first aid cases, hospitalization and emergency treatment etc. 24

What is the HAAD Safety in Heat programme and how can it help?

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• Multi–media– Printed Materials – posters, pamphlets, roll up banners and training

materials and Digital Media - videos and online/websites

• Multi-lingual– English, Arabic, Urdu, Malayalam, Hindi, and Bengali

• Multi-targeted– Four different groups and all sectors where heat stress occurs

• Technical programme – Based on international best practice and research conducted in

Australia and UAE

• To reduce heat illness and heat related in injuries in Abu Dhabi and beyond..

HAAD Safety in the Heat Program

The Program includes:

Information and Resources for:

• Work in heat protocols and procedures• Information and training for workers and supervisors to

recognize heat stress symptoms and to control heat exposure • Guidance on preventative measures• Guidance on First-Aid measures for heat illness• Guidance on good hydration practices • Guidance on assessing and monitor Heat Stress Parameters

(TWL Index)

• To raise awareness of the dangers of heat exposure amongst the target groups and prevention and;

• To provide support and health promotion materials to raise awareness of the issue, increase education and training

• To support the AD EHS Center, EHSMS Sector Regulatory Authorities, EHSMS and other Entities and the Ministry of Labour summer activities and events:

Aims and Objectives of HAAD Safety in Heat Program

Primary target audience:

• Health and Safety Personnel in allIndustrial sectors where workers are exposed to Heat

Secondary target audiences:

• Employers, CEO’s, Business Owners, Supervisors ;• Heat exposed workers from different language groups

Target Groups

2009• Launched on the 20th May 2009 in collaboration with the

Ministry of Labour2010

• Program evaluation, some amendments to the graphics and style, additional resources added such as different language materials and Ramadan posters

• Re-launched for summer 20102011

• Re-launched for summer 20112012

• Has become part of the Abu Dhabi EHSMS regulatory framework

• Re-launched for summer 20122013

• New Look

The Programme so far…2009 -12

Material Development (2009-2012)

Construction (2009) Multi-sector and Ramadan (2010)

EHSMS and 10 Sectors (2012)

DVD/CD Sets

Wide Range of Resources available

HSE Procedure and Training Manual

Technical Information Sheets

Posters/Roll-Up banners Pamphlets

Water cooler

What are the key messages and components in the programme?

Resources for: Supervisors

Information pamphlets in different languages covering:

• What happens to the body when it is exposed to heat

• How heat exposure affects a worker – symptoms

• Prevention of Heat Illness – What you as a supervisor should do

Messages for Workers

Pamphlets in different languages with Key Points to remember

Hydration is the single biggest factor for protection against heat illness

Improving hydration status is key

Key Point 1… Drinking enough water

Come to workwell Hydrated

Maintain adequate Hydration throughout The day

Self AssessHydration

Self Assessment of Hydration Status

Hydration – Important Points to remember

• To come to work fully hydrated:– drink plenty of water before you get to work, at least 1

Litre• To drink plenty of water during the shift

– at least 2 litres every 2-3 hours in summer (or rehydration fluid approved by the employer one to one).

• Remind them if they drink water only when thirsty it is too late.

• To carry a water container with you of at least 1-2 liters to fill regularly.

Key Point 2 … Salt Replacement

POINTS to REMEMBER:

• If electrolyte replacement drinks are provided there is no need to add extra salt to meals

• If someone has high blood pressure they should be checked by a doctor before working in heat or increasing salt intake

• If electrolyte drinks are consumed then they should alternate with a drink of water one to one over the day

Maintain electrolyte Intake/replacement

Key Point 3 … Rest and Recovery

Self-pace work – do not push beyond the bodies limits.

Allow time at night to recover from the heat stress during the day

Provide a well balanced health diet to help the body to recover – avoid coffee, cola and high sugar and fatty foods

Key Point 4 … Heat Illness

Identify Signs of Heat Illness

Encourage the reporting of all signs of heat illness to the supervisor (feeling faint, dizziness, fatigue, headache, nausea, vomiting, cramps).

REMEMBER: HEAT ILLNESS CAN KILL SO BE AWARE!

Posters Remind of Key Points

During Summer:

• Drink at least 2 litres of water every 2-3 hours – Maintain Hydration

• Add a little more salt to your meals – Replace Electrolytes

• In hot weather take regular breaks – Encourage Self Pacing

• Get plenty of sleep at night – Encourage Rest and Recovery

• When unwell tell your supervisor – Encourage Reporting of Symptoms

What about Ramadan, fasting and heat exposure?

POINTS to REMEMBER:

• Try avoid heat exposure as much as possible during Ramadan

• Monitor for signs of heat illness such as skin rashes, dizziness, headaches

• Start the day well hydrated – for Suhoor with your meal eat fruits, vegetables and drink plenty of water and unsweetened fruit juice

• Avoid salty foods at Suhoor

• Drink water and fruit juices at Iftar before eating

• Avoid strenuous activity and rest in a cool place where possible

How do you use the materials on-site?

How do you implement the programme?

• Place posters up in worksites, noticeboards and rest/eating areas on site and in worker accommodation areas

• Place pamphlets on notice boards, in rest areas and worker accommodation sites to be read by workers – use them as a training resource to smaller groups

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Implementation on worksites

• Place urine charts in toilets and urinals

• Show worker videos before and throughout the summer to different language groups and discuss and answer questions

• Train HSE Officers with procedures manual and HSE video, ppt slides

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Implementation on worksites…

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How do you Assess Heat Stress? Environmental Assessment

Thermal work limitRadiant Heat

Dry Bulb Wet Bulb

Globe TemperatureWorking Zones

Relative Humidity

Heat Stress Index

To determine TWL the following must be measured:

Dry Bulb Temperature (ambient air temperature) in degrees °C

Wet Bulb Temperature (affected by the humidity/evaporation) in degrees °C

Globe Temperature (affected by the radiant heat) in degrees °C

Wind speed in metres per second

Assessment of Heat Stress

• Wet bulb temperature is the most important and is measured using a wet bulb thermometer

• WB is the temperature at which water evaporates into the air

• Significant when compared to skin temperaturebecause of the affect it has how much of anindividuals sweat evaporates

• Dry bulb temperature (ambient temp.) is not as important and is measured using a regular thermometer

Air Temperature – Dry Bulb

Radiant Heat – Globe Temperature

• Heat energy transmitted by electromagnetic waves in contrast to heat transmitted by conduction or convection

• Measured using a “globe thermometer” a 150 mm diameter hollow copper ball (painted black) with a standard thermometer in it.

• Significant for workers in the sun or in smelters

Relative Humidity – Wet Bulb Temp.

• Relative Humidity is a percentage of the actual amount of moisture in the air, compared to the maximum moisture that can be taken up by the air at that temperature

• 50% or more of sweat can drop off skin• Only sweat which evaporates off skin

produces cooling• Sweat which drops off just adds to

dehydration load• Dry air means more evaporates and

less drips off keep air dry (low humidity)

Wind Speed – Air Velocity

The higher the wind speed the better (within reason)• Wind speed increases evaporation of sweat• Use fanswhere possible• Ensure ventilation systems are working effectively at

all times

• The Thermal Work Limit (TWL), which has been validated for gulf conditions, is the heat stress index that is recommended by HAAD to enable the safe management of work in heat.

• It gives a measure of the maximum safe work rate for the conditions i.e.: the maximum rate at which heat can be lost to the environment in the given conditions

• If TWL is too low then even low rates of work cannot safely be carried out continuously.

• TWL is calculated from environmental parameters assuming that workers are well hydrated and acclimatised to the conditions and are self-paced.

Thermal Work Limit (TWL)

A HIGH TWL means better working conditions

THERMAL WORK LIMIT

A LOW TWL means poorer working conditions

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THERMAL WORK LIMIT

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TWL – Thermal Work Limit Zones and Interventions for Management of Work in Heat

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Assessing Heat Stress – Equipment Available for TWL

Calor Heat Stress Meter(Australia)

Kestrel Instrument (USA)

Scarlet Tech (Taiwan)

HAAD Online TWL calculator

If individual environmental parameters are known they can also be entered intothe online HAAD TWL calculator to calculate TWL.

How do you get the materials?

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Material Collection

• Complete a material order form

• Collect the materials at HAAD HQ building 1st floor Sunday – Thursday between 9:30am and 2:30pm

• Contact person: Mr. Mohammed Hussain

• Regional Officer: HAAD • mhussain@haad.ae

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Thank You/Questions