Abstract
Heat-related illness and death in the workplace can be prevented by health and safety professionals including occupational health nurses, who can facilitate program planning, measure objectives, and achieve goals for the well-being of all staff.
Keywords
Workplace heat is a hazard that can cause worker illness and death. From 2008 to 2013, 109 heat-exposure deaths, both confirmed and possible deaths, occurred at American worksites (Occupational Safety & Health Administration [OSHA], 2014). Because climate change experts predict increasing average ambient temperatures and frequent, episodic heat waves (Gubernot, Anderson, & Hunting, 2013), workplace heat illness and death incidents may increase unless employers initiate comprehensive preventive programs.
In a review of federal heat enforcement cases from 2012 to 2013, OSHA cited 20 cases under paragraph 5(a)(1) “the general duty clause” of the Occupational Safety and Health Act of 1970 (Arbury et al., 2014). These cases included 13 fatalities attributed to heat exposure, and 7 cases of two or more workers who suffered symptoms of heat illness (Arbury et al., 2014). Non-fatal events, such as heat stroke, heat exhaustion, heat cramps, and heat rash, are far more frequent than fatalities. Often workers do not recognize the signs and symptoms of heat-related illness, or they hesitate to report symptoms to management.
Nurses can play a key role in the prevention of heat-related illness. Key questions to ask workers include the following: Have workers experienced dizziness, lightheadedness, weakness, lethargy, or a change in blood pressure? Have workers asked to leave work or take extended breaks? Has anyone sought health care in response to heat exposure? This information is valuable to assess the extent of the problem.
It is important to discuss the following with employees, management, and safety and health professionals at the worksite (OSHA, n.d.).
Create a program plan and develop SMART objectives. Provide workplace trainings on the signs and symptoms of heat-related illness.
Monitor daily heat index and heat warning advisories to guide program management.
Obtain a wet bulb globe thermometer and determine workload requirements to know whether overexposure has occurred and manage work-rest cycles.
Take into account that working in full sun adds 15° to the heat index.
Hydration: Encourage workers to drink four cups of water per hour; ensure water is available and replenished for each shift.
Rest: Increase ratio of rest to work as environmental temperature and metabolic rate categories increase.
Shade: Whether outdoors or indoors, ensure there are shaded and cool places for workers to take breaks.
Acclimation: Ensure new hires or workers returning after an absence acclimate to a hot environment.
Change work hours to minimize time spent in the sun or hot environment.
Monitor and evaluate the program: Were program objectives met?
Preventing heat-related illness is the responsibility of all company staff. Nurses can spearhead programs on any budget with the support of management and workers. Together with management and employees, occupational and environmental health nurses can mitigate heat-related illness in the workplace. More information can be found on occupational heat exposure at https://www.osha.gov/SLTC/heatillness/heat_index/pdfs/all_in_one.pdf
Footnotes
The author(s) declared no potential conflicts of interest and received no financial support with respect to the research, authorship, and/or publication of this article.