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Heat Illness Prevention Program (HIPP)

Heat Illness Prevention Program

(HIPP)

Insert Department/Division/Bureau Name

March, 2011


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 IndexC. Water Needed Daily - worksheet D. Environmental and Personal Risk Factor DefinitionsE. Heat Related Illness, Symptoms and First Aid F. Training Sign in SheetG. Emergency Response Procedures – POSTED AT WORKSITEH. Resources

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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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II. Responsibilities

General Manager, Assistant General Managers, and Division ManagersResponsibilities 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).

III. Compliance

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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)

Shade: Shade is defined as the blockage of direct sunlight; some sources of

shade may include trees, canopies or buildings.-5-


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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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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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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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 all employees working in the sun remain aware of how their bodies are handling

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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.

SunburnSymptoms 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 RashThis 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 CrampsThe 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 ExhaustionSymptoms 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 SunstrokeSymptoms 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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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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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.

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


(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.

(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 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.

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).

HIPP APPENDIX B


Heat Index


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.


HIPP APPENDIX D

Environmental and Personal Risk Factor Definitions

Air temperature/humidityThere 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 90F, especially with heavy work, heat risk reduction needs to be a major concern.

Air movementConvection 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 durationIn 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 employeesWith 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:

AgeOld 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.


Water consumptionCal/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 diureticsDrinks 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 acclimatizationAcclimatization 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

atropine Inhibits sweating; and Creates cardiac disturbances.

Diuretics (medications that increase urination)

Causes dehydration; Decreases cardiac output; and Inhibits sweating.

Stomach (gastrointestinal) drugs that contain atropine (such as Donnatal) Inhibits sweating.

Tranquilizers and some over-the-counter sleeping pills

Affects ability to recognize increases in body temperature; and

Affect thirst thresholds.

Antidepressants and antipsychotics (such as Prozac, Thorazine, Haldol)

Affects ability to recognize increases in body temperature; and

Increases body temperature.

Antihistamines (allergy medications such as Benadryl)

Constricts blood vessels; Inhibits sweating; and Increases body heat.

Heart (cardiovascular) drugs, including beta blockers (such as Blocadren) and

diuretics (such as Diuril)

Decreases cardiac output and later blood flow; and

Causes dehydration.

Parkinson's disease medications Inhibits sweating; and Creates cardiac disturbances.

2007 Washington State Department of Labor and Industries. Division of Occupational Safety and Health


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 Disorder

Symptoms First Aid

Sunburn - Redness and pain- In severe cases: swelling of skin,

blisters, fever, and headaches

Ointment for mild cases if blisters appear. If breaking occurs, apply dry sterile dressing. A physician should see serious, extensive cases.

Heat Rash - Red clusters of pimples or small blisters on the neck and upper chest, in the groin, under the breasts, and in elbow creases

Keep the affected area dry. Dusting powder may be used to increase comfort, but avoid using ointments or creams – they keep the skin warm and moist and may make the condition worse.

Heat Cramps - Muscle pains or spasms usually in the abdomen, arms, or legs

- Heavy sweating

Stop all activity and sit in a cool place. Drink water, clear juices, or sports beverages such as Gatorade. Seek medical attention if pain does not subside in one hour.

Heat Exhaustion

- Heavy sweating and weakness- Skin is cold, pale and/or clammy- Muscle cramps- Tiredness, weakness, dizziness,

headache- Fast and weak pulse rate- Fast and shallow breathing- Nausea, fainting or vomiting

Get out of the sun and into an air-conditioned environment. Lie down and loosen clothing. Drink cool, non-alcoholic beverages. Take a cool shower, bath, or sponge bath. If vomiting continues, seek immediate medical attention.

Heatstroke (or sunstroke)

- High body temperature (106°F or higher)

- Hot dry skin (no sweating) - Rapid and strong pulse- May be extremely disoriented- Possible unconsciousness- Possible convulsions

Heatstroke is a severe medical emergency. Summon medical assistance or get the victim to a hospital immediately. Delay can be fatal. Move the victim to a cooler 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).


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).


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

http://www.osha.gov/SLTC/heatstress/


HIPP APPENDIX FSign in Sheet

Title: Heat Illness Prevention TrainingDate: ______________ Length of Training__________

Employee Name Initials Date of Completion

** Attach a short description of material covered along with any handouts given to employees**


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.


HIPP APPENDIX H

Resources

Cal/OSHAhttp://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 Safetyhttp://www.ccohs.ca/oshanswers/phys_agents/heat_health.html

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

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

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

http://www.bt.cdc.gov/disasters/extremeheat/faq.asp

http://www.ccohs.ca/oshanswers/phys_agents/heat_health.html

http://weather.noaa.gov/weather/CA_cc_us.html

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

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