Heatstroke Prevention

How Can Road Construction Crews Stay Out of Heat Stroke Danger?

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Heat stroke is a risk in all forms of construction, but it’s elevated for road construction workers. The job involves bursts of heavy labor, and if construction is being done during the day, there may not be shade nearby. On major highways, the nearest source of shade may be across several high speed lanes of traffic. For these workers, it may seem like there’s no escape from the sun.

During the paving process, heat is more of a concern, as asphalt is applied at temperatures of 200 degrees Fahrenheit or hotter. That’s a lot of radiant energy, exposing construction crews to elevated temperatures.

Road construction workers need protection from heat exhaustion and heat stroke. If not treated promptly, heat stroke can lead to long-term disability or death, so prevention is critical. To do that, construction sites need the right processes and the right equipment.

Keep an Eye on the Thermometer

The first step in preventing heat illness is knowing when the heat is too much. Every worksite should monitor temperature constantly, and be ready to take measures when the heat index is elevated. The more people watching the temperature, the better, as preventing heat illness should be everyone’s goal, from supervisors to the crew. It’s especially important that workers know the temperature, as they are usually the first to notice signs of heat illness in other workers.

Heat cards are an ideal way for everyone at the site to monitor the temperature. Heat cards are embedded with thermochromic liquid crystals, or LCs, and these crystals alter their orientation as the temperature rises and falls. This causes them to change color, and they are accurate within a single degree Fahrenheit. Heat cards allow for temperature monitoring on demand at a glance, and they can also be printed with company branding, reference information or emergency contacts. This can be lifesaving if a worker is found debilitated by heat stroke and cannot be easily moved.

Information is Critical

Many companies are integrating heat illness prevention into their occupational safety programs, and a major part of these programs is information. It’s essential that everyone know what the company’s processes are regarding heat illness prevention, risk reduction and what to do in the event of an emergency.

Efforts in informing an entire workforce should be multifaceted. Verbal instruction and training are important, but so are reminders. Some construction sites pass on safety policies but fail to reinforce them, which leads to lapses in safety. A simple solution to this is posting signage around the worksite that provides critical safety information.

As long as workers know how to prevent heat illness, doing so is easy. Calculating the heat index, gauging fluid intake and scheduling rest breaks are effective at preventing heat stroke. Informational signage and heat cards can help remind workers to do all three.

There’s Safety in the Shade

The chances of heat stroke elevate when workers are directly exposed to the sun, and road construction workers are exposed to the sun for long stretches of time. There’s no getting away from it in some cases, and it’s impossible for people to cool down if they can’t. What’s worse, if shade is available, it may only be available for a short time, and that shaded area recently exposed to the sun will still be radiating heat.

Construction workers can avoid this problem by setting up tents on the jobsite. Tents are simple, yet perfect solutions to the no-shade problem, as long as companies select the right tent. In this case, the right tent is one that’s built with a metal frame, and preferably a heavy duty, aluminum frame. Aluminum is light, so it’s easy to carry and maneuver, and it’s corrosion resistant, so it can handle exposure to weather and air that’s heavy with salt.

Tents can be set up quickly and moved as needed, so as work shifts to another section of the road, the tents can be broken down and moved easily. Tents can also be kept in one spot throughout the day, and that keeps it cooler. Some tents come with walls, too, and this can insulate the inside from the heat outside. Combine the tent with a powerful fan, set up a hydration station inside, and workers have a place they can retreat to for rapid cooling.

Road construction crews are constantly challenged by heat stress, whether it comes from the environment, from exertion or from heated paving materials. Construction companies, their management and their crews must be aware of these heat risks at all times, as they can lead to debilitating heat exhaustion and potentially deadly heat stroke. With the right equipment and processes, though, it’s possible to stay on top of heat-related hazards and ensure workers are protected from heat stroke.

How to Recognize Heat Stroke on the Jobsite

How to Recognize Heat Stroke on the Jobsite

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Heat injuries send thousands of workers to the emergency room every year, and kill dozens in the process. Yet, every one of these injuries and deaths are preventable with the right safety processes and equipment in place.

The first step to heat injury prevention, though, is knowing what heat stroke looks like. Heat stroke is the most serious form of heat illness and can be fatal if not treated. Even if treated, heat stroke can result in permanent complications, so precautions are a must.

What Are the Signs and Symptoms of Heat Stroke?

Heat injuries progress from less severe to more severe quickly, and heat stroke is at the severe end of this progression. What begins as heat exhaustion – a non-emergency that resolves completely with treatment – progresses to heat stroke if the worker isn’t removed from hazardous conditions.

When heat stroke strikes, it presents with the following symptoms:

  • Elevated body temperature (can reach as high as 106 degrees Fahrenheit or above)
  • Severe confusion or altered mental state
  • Excessive sweating or a complete lack of it
  • Seizures
  • Dizziness
  • Ataxia or loss of balance
  • Elevated or reduced blood pressure
  • Elevated heart rate
  • Loss of consciousness

Heat stroke is always a medical emergency and therefore requires emergency treatment to manage. Without treatment, heat stroke can be fatal, and delayed treatment can result in significant permanent injury, including traumatic brain injury.

Ideally, heat stroke is stopped before it emerges, when less severe forms of heat illness are present. Heat exhaustion, for example, presents with some of the same symptoms as heat stroke, but without the loss of consciousness or confusion that signals heat stroke. If workers and safety personnel are alert to these signs, then the person suffering from heat exhaustion can be removed and allowed to recover without an emergency response.

What is the Recommended Response if Heat Stroke is Suspected?

If heat stroke does emerge, an immediate response is required. In many cases, there’s only a short window of time to bring the person’s body temperature back into safe ranges, or the risk of permanent injury goes up. This could be as brief as 30 minutes, so time is of the essence.

The goal is to bring the patient’s body temperature down as quickly as possible. First, call 911 and ensure emergency personnel are enroute as soon as possible.

If waiting for emergency responders to arrive, measures must be taken to reduce the patient’s body temperature. The best way to do this is to immerse the patient in cold water. If that’s not possible, the patient’s clothing should be removed and cool water applied their skin. This can be done by soaking cloths in cold water and placing them on the afflicted person. The worker should be removed to a cool, shaded place for this, and ideally in an area with circulating air. Target the neck, armpits and groin when placing cloths or ice packs, as this is where heat tends to concentrate. Remain with the patient until emergency personnel arrive.

Heat Stroke is a Medical Emergency, so Organizations Need a Heat Safety Plan in Place

Given the potentially fatal nature of heat illnesses, many organizations opt to put together a heat-specific safety plan in place for their worksites. Such a plan typically includes the following:

  • The names and contact information of the people responsible for enforcing the plan
  • The name, address and contact information of a nearby emergency medical facility
  • The location and nature of any heat-related hazards on the job site
  • An action plan if a heat-related emergency occurs
  • The location of any onsite resources intended for treating heat illnesses
  • The preventative measures in place for heat-related emergencies

The point of this plan is to articulate what the company does to prevent heat illnesses. This may include checking worker vitals regularly, switching to an alternative work schedule or rotation, setting up hydration and cooling stations, or providing personnel with temperature-monitoring tools so they can respond when heat hazards are at their worst.

Monitoring the Temperature is Critical for Field Workers and Can Raise Awareness of Heat Stroke

100 percent of heat injuries can be prevented, and it’s easier to prevent those injuries if your field personnel know what conditions they’re facing. The problem is, the temperature can climb from hot to dangerously hot without anyone noticing, unless they’re monitoring temperature data.

This information is clearly most important for field employees where they work. That being the case, it makes sense to arm those employees with temperature-taking tools.

An inexpensive, easy-to-use and lightweight option are liquid crystal thermometers embedded in a twic card or something similar. Liquid crystal thermometers are reliable within a couple of degrees and can provide an instant check on ambient temperature.

Heatstroke 101: What You Need To Know

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Knowing the signs of heatstroke are important for anyone who works in a high temperature environment. This includes those that work outdoors, where hot, humid days produce heat-related illnesses in rapid fashion. At particular risk are people who labor outside and those who participate in organized sports, as the vast majority of heatstroke cases are brought on by extended physical exertion. Even those who are otherwise fit and healthy can be affected by heatstroke, so prevention and treatment methods should be standard in any high risk environment.

What are the signs of heatstroke?

Heatstroke is one of several heat-related illnesses, but is widely considered to be the most severe. Unlike other forms of heat-related illnesses, like heat cramps, heat rash or heat exhaustion, heatstroke is an immediate medical emergency that can result in death or permanent injury if not treated promptly. Recognizing what heatstroke looks like is the first step in preserving life, and the signs look like this:

  1. Elevated temperature – Heatstroke is usually diagnosed symptomatically, but the defining characteristic of the condition is a temperature in excess of 105 degrees Fahrenheit. At this temperature, the body’s organs are at risk of sustaining damage. Indicator tools like heat cards can alert workers to dangerous outdoor temperatures, but the only way to confirm the presence of heatstroke is to get an accurate temperature reading from the affected person. Rectal thermometer readings are generally regarded as the most accurate.An important note – fever and heatstroke are not the same thing. Fevers are caused by physiological mechanisms in response to infection or illness. Heatstroke is a product of the body’s thermoregulatory mechanisms being overwhelmed. When the body’s thermoregulation is defeated, it is normally due to a combination of exertion, excessive environmental heat and impaired heat loss.
  2. Dizziness, mental confusion or weakness – These symptoms are often present before true heatstroke sets in, so they should serve as troubling red flags. Heat exhaustion is the standard term for heat illness that results in mental impairment or weakness, and always precedes heatstroke.
  3. Excessive sweating or a complete lack of sweating – Excessive sweating may be present in people who are exerting themselves during the onset of heatstroke. A complete lack of sweating is an alarming symptom, as it suggests that the body is severely dehydrated and unable to remove heat through sweating. At this stage, rapid temperature increase is imminent and potentially fatal.
  4. Loss of consciousness – As heatstroke progresses, loss of consciousness is possible and signals a high risk of neurological or cardiological complications. Loss of consciousness is usually an indicator of a poorer prognosis, even if the patient is able to fully recover from the episode. Lack of consciousness can also make some forms of treatment more difficult, so prevention should be emphasized so that people do not lose consciousness due to heatstroke.

If any of these signs are present, it is paramount that the person is immediately removed from the high temperature environment and administered treatment. As heatstroke is an emergency medical situation, emergency personnel should be alerted at once.

How to Prevent and Treat Heatstroke

According to The Journal of Emergency Medicine, heatstroke kills more than 600 people in the U.S. every year. The vast majority of these deaths occur in people who are at a higher risk of heatstroke, such as the very young or old, people with other medical conditions and people on medication that affects their thermoregulatory mechanisms. However, death is still a possible outcome in anyone who does not receive treatment. And death is not the only severe consequence of heatstroke. Researchers with the University of Chicago Medical Center studied dozens of patients affected by the 1995 Chicago heat wave, and found that even when patients fully recovered from heatstroke, they were often profoundly affected by the episode, even years later. Specifically, the researchers found that about half of the studied patients died within the following year, and many others had severe functional impairments related to the heatstroke.

In short, heatstroke prevention is not just a life or death situation – it is also about preserving the patient’s quality of life over the long haul. For this reason, prevention is the best cure, and workplaces and sports teams can minimize the chances of heatstroke by doing the following:

  1. Know when hot is too hot – The single biggest mistake that people, managers and coaches make is not taking the heat and humidity seriously. There is often a stigma attached to taking it easy, even when it’s hot outside. This is a dangerous stigma to abide by, as the chances of rapid heatstroke increase as the temperature rises. It’s not enough to just look at the thermometer either, as high humidity can greatly increase the heat index, or the perceived outdoor temperature. On a humid day, heat indexes can run up to 10-15 degrees hotter than the listed temperature, and indexes above the 100s mean dangerous conditions for outdoor workers and athletes. When the temperature gets this hot, consider bringing activities indoors, if possible.
  2. Enforce mandatory rest periods – If work or play cannot be brought inside, then workers should be required to rest a certain amount of time every hour. For example, if temperatures are above 100 degrees outside, workers should be required to rest at least 20 minutes out of every hour, and ideally inside. As temperatures climb, rest periods should be lengthened and workers monitored to ensure they are getting enough downtime.
  3. Dress codes that emphasize heat regulation – Impaired heat loss mechanisms are a key cause of heatstroke, but this can be addressed to an extent by promoting a safe dress code. This should include light fitting clothes that allow for better ventilation, lightly colored clothing that does not absorb as much sunlight and wider brimmed hats that block sunlight from reaching the face and neck.
  4. Ready access to rehydrating fluids – Dehydration is a ubiquitous feature of heatstroke, which suggests that many people who suffer from it did not hydrate adequately prior to symptoms. The problem is that most people don’t hydrate until they become thirsty, but thirst is an inadequate measure for determining when someone has lost too much fluid. For this reason, water or electrolyte drinks should be available at all times, and workers encouraged to rehydrate regularly, even when not thirsty.
  5. Carry helpful temperature indicators like heat cards – Heat cards equipped with liquid crystal thermometers (also called thermochromic liquids) are easily portable and can provide continuous monitoring of ambient temperature. With a heat card, safety personnel and workers know exactly when exterior temperatures are entering unsafe territory.

If worksites and sports teams rigorously apply these prevention methods, the chances of anyone suffering from heatstroke will be extremely low. However, if someone is suspected of experiencing heatstroke, treatment must be applied without hesitation. The goal of treatment is to reduce the patient’s core temperature to 102 degrees Fahrenheit as quickly as possible. At this temperature, the patient is unlikely to experience further damage due to heatstroke and is also unlikely to experience “rebound” hyperthermia.

There are two methods of treatment that are generally considered to be the most effective. They include:

  1. Ice water bath immersion – Full body ice water immersion is considered to be the fastest method of temperature reduction possible. Ice water is able to bring core temperature down to 102 degrees within 20-40 minutes, which is typically fast enough to guarantee a positive prognosis. The problem with ice water bath immersion is that it is particularly uncomfortable and possibly dangerous if the patient is unconscious, as they may slip below the water and drown. Close monitoring of the patient is therefore necessary.
  2. Evaporative heat loss methods – This involves spraying the patient with water and placing a high powered fan next to the patient to wick away excess heat. Water is capable of absorbing a lot of heat in a short amount of time, so constant reapplication of water can also reduce core temperatures in a hurry. Although it is completely safe to use in unconscious patients and generally makes it easier to resuscitate the patient, if need be, it is not as effective as ice bath immersion. However, evaporative heat loss is usually easier to execute, as an ice bath is not always a feasible option.

There are other methods of reducing temperatures, including delivery of intravenous cold fluids, gastric or rectal lavage and application of cold, wet towels. None of these rival ice water bath immersion or evaporative heat loss in terms of effectiveness.

Heatstroke can be a killer, and even when it doesn’t result in death, it can leave the sufferer in poor shape for the rest of their life. To guarantee the near and long-term safety of workers or athletes, safety personnel must take heatstroke seriously and avoid it at all costs.