Because the incidence of heat stress depends on a variety of factors, all workers, even those not wearing protective equipment, should be monitored. HAZWOPER workers wearing permeable clothing (e.g., standard cotton or synthetic work clothes), follow recommendations for monitoring requirements and suggested work/rest schedules in the current American Conference of Governmental Industrial Hygienists' (ACGIH) Threshold Limit Values for Heat Stress. If the actual clothing worn differs from the ACGIH standard ensemble in insulation value and/or wind and vapor permeability, change the monitoring requirements and work/rest schedules accordingly. For workers wearing semi-permeable or impermeable encapsulating ensembles, the ACGIH standard cannot be used. For these situations, workers should be monitored when the temperature in the work area is above 70°F (21°C).
To monitor the worker, measure:
- Count the radial pulse during a 30-second period as early as possible in the rest period.
- If the heart rate exceeds 110 beats per minute at the beginning of the rest period, shorten the next work cycle by one-third and keep the rest period the same.
- If the heart rate still exceeds 110 beats per minute at the next rest period, shorten the following work cycle by one-third.
- Use a clinical thermometer (3 minutes under the tongue) or similar device to measure the oral temperature at the end of the work period (before drinking).
- If oral temperature exceeds 99.6°F (37.6°C), shorten the next work cycle by one-third without changing the rest period.
- If oral temperature still exceeds 99.6°F (37.6°C) at the beginning of the next rest period, shorten the following work cycle by one-third.
- Do not permit a worker to wear a semi-permeable or impermeable garment when his/her oral temperature exceeds 100.6 °F (38.1 °C).
Body water loss, if possible measure weight on a scale accurate to ±0.25 lb at the beginning and end of each work day to see if enough fluids are being taken to prevent dehydration. Weights should be taken while the employee wears similar clothing or, ideally, is nude. The body water loss should not exceed 1.5 percent total body weight loss in a work day. Initially, the frequency of physiological monitoring depends on the air temperature adjusted for solar radiation and the level of physical work. The length of the work cycle will be governed by the frequency of the required physiological monitoring.
Proper training and preventive measures will help avert serious illness and loss of work productivity. Preventing heat stress is particularly important because once someone suffers from heat stroke or heat exhaustion, that person may be predisposed to additional heat injuries. To avoid heat stress, management should take the following steps:
Adjust work schedules: - Modify work/rest schedules according to monitoring requirements.
- Mandate work slowdowns as needed.
- Rotate personnel: alternate job functions to minimize overstress or overexertion at one task.
- Add additional personnel to work teams.
- Perform work during cooler hours of the day if possible or at night if adequate lighting can be provided.
- Provide shelter (air-conditioned, if possible) or shaded areas to protect personnel during rest periods.
Maintain workers' body fluids at normal levels. This is necessary to ensure that the cardiovascular system functions adequately. Daily fluid intake must approximately equal the amount of water lost in sweat, i.e., 8 fluid ounces (0.23 liters) of water must be ingested for approximately every 8 ounces (0.23 kg) of weight lost. The normal thirst mechanism is not sensitive enough to ensure that enough water will be drunk to replace lost sweat. When heavy sweating occurs, encourage the worker to drink more. The following strategies may be useful:
- Maintain water temperature at 50° to 60 °F (10° to 15.6°C).
- Provide small disposable cups that hold about 4 ounces (0.1 liter).
- Have workers drink 16 ounces (0.5 liters) of fluid (preferably water or dilute drinks) before beginning work.
- Urge HAZWOPER workers to drink a cup or two every 15 to 20 minutes, or at each monitoring break. A total of 1 to 1.6 gallons (4 to 6 liters) of fluid per day are recommended, but more may be necessary to maintain body weight.
- Weigh workers before and after work to determine if fluid replacement is adequate.
Encourage workers to maintain an optimal level of physical fitness:
- Where indicated, acclimatize workers to site work conditions: temperature, protective clothing, and workload.
- Urge workers to maintain normal weight levels.
- Provide cooling devices to aid natural body heat exchange during prolonged work or severe heat exposure.
Cooling devices include:
- Field showers or hose-down areas to reduce body temperature and/or to cool off protective clothing.
- Cooling jackets, vests, or suits.
- Train workers to recognize and treat heat stress. As part of training, identify the signs and symptoms of heat stress