If applicable,  new employees should complete a physical examination prior to heat exposure to identify pre-existing medical conditions that are associated with heat intolerance. Physical exams must be conducted in compliance with HIPAA and federal regulations regarding employee protection.

‌During Onboarding, employers should inform employees of the following:

• Risk factors associated with heat-related illness
• Signs and symptoms of heat-related illness
• Strategies to mitigate heat-related illness (heat acclimatization, hydration, body cooling,etc)
• Locations of hydration and rest stations
• Details of the heat safety plan
• The appropriate chain of communication that must occur during an emergency

What is an Emergency Action Plan and why is it important?

Emergency Action Plans (EAPs) contain vital information on policies and procedures that should be taken during a potentially catastrophic event. While emergencies are rarely predictable, they do occur and the response that occurs in the first 5-10 minutes will likely dictate the outcome.  Everyone involved (supervisors, workers, security, etc.) be educated on, have access to and rehearse the EAP. Rehearsal should occur at least annually, but the more frequent the rehearsals, the more efficient the response when an emergency arises.
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‌Once an EAP is established, it is imperative that it is implemented effectively via posted copies/distribution, education on the EAP for all personnel, and routine rehearsals of the EAP.

‌What can I do to prepare for an emergency?

‌What is my role?

In most instances, workers are going to the best first people to respond to an emergency. It is important to be able to recognize the signs and symptoms associated with heat illness and cardiac emergencies. You should know who the first aid responder is on your shift and the best way to get a hold of them if an emergency. If you are the first person to respond to an emergency, you should know where the nearest phone is to call 911 and then move individual inside or to a shaded place and remove excess clothing.
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‌Get help. Send someone to find the supervisor or give them a call from your phone.

1. Commit to a heat safety plan

Safety must come FIRST. Your organization’s commitment to a heat safety plan represents a dedication to keeping your workers safe from the dangers of heat. By going the extra mile and caring for your employee/worker's health, well-being, and safety, your organization will develop a strong reputation. Committing to a heat safety plan can also reap financial rewards through heat safety training and reducing productivity losses associated with heat stress (Decreased worker's compensation, decreased time out of work, etc).
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‌If your organization has multiple worksites, it may require multiple heat safety plans (e.g., large corporations, power plants).

‌2. Designate a heat safety officer for your company and identify specific roles for management team

Once your organization is committed, they will need to designate roles and make sure management is on board. Ask the following questions:

• Who will be creating and reviewing heat safety plans?
• Who is supervising workers to ensure they are following the plan?
• Who will train the employees?
• Who will assess the effectiveness of the heat safety plan after implementation?

‌Creating a safety committee to discuss the implementation of the heat safety plan is  important to ensure that the heat safety plan is feasible. Involving the workers with the heat safety committee will aide in determining feasibility while encouraging them to follow the plan once it is in place.

‌3. Examine your organization’s current adoption of heat safety practices

Examine what policies your worksite already has in place to protect workers from heat exposure. Safety officers and employers should ask themselves the following questions:

• Do we have a specific written heat safety plan in place?
• If so, what are its components? Are the current guidelines evidence-based?
• If not, does the organization already instill safety practices that could also protect workers from heat stress

Be prepared to create or alter your heat safety plan based on what you found while reviewing your current policies. Your heat safety practices should be made to follow the current standard guidelines and be evidence-based to best protect your workers from heat illness.

‌4. Assess worksite safety hazards

To optimize heat safety, you must identify what heat hazards currently exist in your organization. For example, are workers performing work around radiant sources of heat, such as ovens? Safety officers should:
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• Inspect all job sites for hazards.
• Review surveillance data for accidents, injuries, etc related to heat.
• Get feedback from your workers. What heat hazards do they feel impact their health and productivity?

5. Create your heat safety plan!

Now that you’ve: 1) committed to heat safety, 2) created a team, and 3) assessed current policies/procedures and workplace hazards associated with heat, it's time to create the plan!
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‌Utilizing the recommendations created in the published occupational heat safety document (pending publication) will help guide employers and safety managers with the creation of a heat safety plan.
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‌Organizations should reach out to heat safety experts at NHSC to review the plan prior to implementation.

6. Gather heat safety resources, training material, and supplies

Once your organization has created a heat safety plan, the resources, training materials, and supplies will need to be collected or created. Utilize the resources on this site or others such as OSHA or NIOSH to translate the heat safety plan to your workers.
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‌Training materials should be created for the onboarding process and annual heat safety training. Once a new plan is implemented, supervisors should be trained  to ensure they understand the new standards for surveillance and safety purposes. Once workers are trained, all employees (workers and supervisors) must confirm their readiness to implement the plan. Workers should know exactly what to do and when they need to do it. No plan is perfect, so supervisors should be prepared for surveillance and feedback following the implementation of the heat safety policies.

7. Continuing education: always update your plan!

As new research comes out on heat safety, more occupational heat safety recommendations will be offered. It's important to continuously educate yourself and others on new developments in the world of heat safety and revise your heat safety plan accordingly.

As a supervisor, you must be aware of workers who are at greater risk of developing a heat-related injury or illness. Workers who have the following conditions are at an increased risk for heat illness:

Non-Modifiable

• Type 1 Diabetes
• Heart Disease
• Autonomic Dysfunction
• Hyper- and Hypo-hidrosis
• Kidney Pathology
• Medications that affect thermoregulation, central nervous system function and sodium balance

Modifiable

• Sedentary Lifestyle
• Type 2 Diabetes
• Obesity

If you have workers with any of these conditions, the following precautions should be taken prior to occupational exposure in a hot environment:

• Identification of the pre-existing condition through medical monitoring
• Pre-placement evaluation
• Fit-for-duty evaluation

The following education and preparation should be encourage for the worker:

• Proper hydration
• Adequate sleep
• Increased fitness levels
• Notifying a supervisor of recent illness

Fatality rate = 0.22 per million workers

359 occupational heat-related deaths were identified between 2000 and 2010, which corresponds to a fatality rate of 0.22 per 1 million workers. Gubernot et al. (2014) Heat-exposed agricultural workers were 14% more likely to experience a traumatic injury compared to non-heat exposed agricultural workers. Spector et al. (2019)
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Problem? 13.3 MILLION workers perform work in heat per day!

Help us keep workers safe from heat-related illnesses and injury!

Heat Exhaustion

• Core temp < 105°F
• Irritability
• Fainting
• Decreased muscle coordination
• Dizziness/Light-headedness
• Headache
• Chills
• Nausea or vomiting
• Diarrhea
• Decreased blood pressure
• Pale
• Fatigue
• Heavy Sweating
• Weakness
• Decreased Urine Output/Dehydration
• Hyperventilation

Heat Stroke

• Core Temp > 105°F
• Irritability, irrational behavior, emotional instability
• Altered consciousness
• Disoriented/confused
• Dizziness
• Headache
• Looks "out of it"
• Nausea or vomiting
• Diarrhea
• Muscle cramps, loss of muscle function/balance, inability to walk
• Collapse or staggering
• Feeling sluggish
• Profuse sweating (or dry skin?)
• Decreasing performance or weakness
• Dehydration, dry mouth, thirst
• Rapid pulse, low blood pressure, quick breathing

Emergency Procedures