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Norris Production Solutions Middle East LLC

Heat Stress Management Procedure


Effective Date: August 1, 2011 Date of last review: May 1, 2011 Date of next review: May 2013

The goal of this procedure is to minimize the detrimental effects of excessive heat on NPS employees who are required to work with elevated temperatures. Effective measures to prevent heat stress vary by work unit, job and the work environment. Because each situation is different, general possible preventive measures are in this procedure.

1. Heat Stress
Heat Stress is influenced by several risk factors: climatic conditions, the work environment, demands of the work, clothing and personal characteristics. 1.1 Climatic and environmental conditions that affect the risk of heat-related disorders are air temperature and humidity, air movement, and the temperature of surrounding surfaces which affects radiant heat exchange. 1.2 Demands of the work influence the stress on the temperature regulation system. Individual responses to a given work load vary but, as an employee expends more energy, the bodys internal metabolic heat production rises. This increases stress on the cardiovascular system to regulate body temperature (i.e., by increasing blood flow to skin). Work-related factors that influence heat stress include work rate, level of physical effort, and duration of activity. 1.3 Clothing characteristics such as insulation, permeability, weight, fit and ventilation affect the bodys ability to regulate internal temperatures. Other factors that may increase the risk of heat-related disorders include additional equipment, the use of a respirator, or other personal protective equipment (PPE). 1.4 Personal characteristics such as age, weight, previous heat stress injury, underlying medical conditions (e.g., diabetes, cardiovascular disorders, chronic pulmonary disease, and thyroid disorders), medication use and overall health and physical fitness contribute to an employees susceptibility of contracting a heat-related illness. 1.5 Working in an environment with heat stress not only increases the risk for specific heat related conditions such as heat exhaustion and heat stroke, but also increases the risk for other adverse events. Studies show link between heat
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stress (e.g., lower mental alertness and physical performance) to an increase in workplace accidents. 2. SIGNS AND SYMPTOMS OF HEAT-RELATED DISORDERS Heat related disorders may occur when there is an exposure to heat risk factors. The chart below illustrates some of the signs and symptoms associated with heat stress. If the employee is experiencing any of these symptoms, the employee should be taken to the emergency room for treatment immediately.
Disorder Dehydration Heat Exhaustion Signs Loss of work capacity Delayed response to stimuli High pulse rate, confusion, anxiety Profuse sweating Low blood pressure Pale face, or flushing Body temperature increased but below 104 degrees F. Excessive thirst, decreased urine output Skin eruptions Red face Mental status changes such as Disorientation, Confusion or Irritability Hot, dry skin Erratic behavior Collapse Shivering Body temperature >104 F Incapacitating pain in muscle Symptoms Fatigue Weakness Dry mouth Fatigue, malaise Weakness Blurred vision Dizziness Headache Nausea Loss of appetite Itching skin, prickly sensation May be same as those for heat exhaustion (see above)

Heat rash Heat Stroke

Heat Cramps Heat Syncope

Brief fainting or near fainting behavior

Muscle cramps (abdominal and lower extremities) Fatigued muscles Blurred vision

2.1. Heat exhaustion occurs when the core body temperature rises above normal. It is caused by insufficient fluid intake while exposed to extreme heat for prolonged period without rest. Symptoms include sweating, extreme weakness or fatigue, giddiness, dizziness, nausea, or headache. The victims skin will be clammy and moist; the complexion will be pale or flushed. The body temperature is usually normal or slightly higher. For treatment, lay victim in a cool shady spot. Elevate feet and loosen clothing. Pour water on victim and fan to cool. Seek medical attention immediately.
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2.2. Heat Rash may occur in hot and humid environments where sweat is not easily removed from the surface of the skin by evaporation. When extensive or complicated by infection, heat rash can be so uncomfortable that it inhibits sleep and impedes a workers performance, or it may result in temporary total disability. Treatments include relocating to a cool place and allow the skin to dry. 2.3. Heat stroke (hyperthermia) is a life threatening emergency and requires immediate medical care. Heat stroke occurs when the bodys thermoregulatory mechanisms fails to function and the main avenue of heat loss (cooling and evaporation of sweat) is blocked. Heat stroke develops during extreme exertion in hot, humid environments, influenced by inadequate fluid and mineral salt intake. Symptoms include lack of sweating, mental confusion, disorientation, unconsciousness, headache, flushed dry skin, nausea, and elevated body temperature. Deep body temperatures that may be greater than 41 Celsius characterize heat stroke. The high body temperatures cause the cells of the brain, heart and kidneys to become dysfunctional. First aid treatment for heat stroke: Aggressively cool victim by moving to shady cool place Lay victim on his back unless there is active vomiting or seizures Elevate victims legs Remove all outer clothing Attempt to lower body temperature by soaking in ice bath or water Get victim to the medic/hospital as quickly as possible

2.4. Heat Syncope or Fainting is caused by pooling of blood in the legs and skin from prolonged static posture and head exposure. Un-acclimatized workers required to stand in one position for extended periods of time are at the greatest risk. Symptoms include blurred vision and fainting. The body temperature will be normal. Preventive measures include moving around rather than standing still. Usually the victim will recover quickly after drinking water and lying down.

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2.5. Heat Cramp are characterized by painful spasms of the muscles, caused by loss of electrolytes in the body. Tired muscles, those used for performing the work, are usually the muscles most susceptible to cramps. Cramps my occur during or after working hours or during resting periods. Treatments include taking liquids by mouth or saline solutions intravenously for quicker relief. If medically determined to be required. There is no evidence that muscle injury occurs as a result of cramps. There is normally no change in the patients temperature, consciousness or vital signs. Salt tablets alone are not recommended as they often pass through the digestive system undigested and may induce vomit. Any questions regarding heat-related health disorders (signs, symptoms, prevention, or treatment) should be directed to: Health, Safety and Environment Manager Norris Production Solutions Middle East LLC PO Box 1429, PC 112 Ruwi Muscat, Sultanate of Oman Or by email: SBALUSHI@NPSDOVER.COM Or by phone: +968 24566140 / +968 94057576 3. PREVENTIVE CONTROLS A control is a mechanism used to minimize or eliminate an exposure to a hazard, such as heat. There are three types of controls (e.g. engineering, administrative and personal protective equipment) that can be implemented to reduce exposure to excessive heat. Each person and situation is unique, so controls and their application will vary. Following a few basic precautions can prevent heat-related health problems. A variety of engineering controls including cooling by shades may be helpful. Shading will also protect employees from radiant heat sources. Other controls include but not limited to: Cooling fans Equipment modifications Use of power tools to reduce manual labor Protective clothing

Some preventive controls for heat stress: 3.1 Hydration: The human body is highly dependent on adequate fluids and minerals to function properly. Adequate water intake is the single most important
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factor in avoidance of heat injury. In a hot working environment, it is not unusual to lose a liter of water per hour. If the loss is not replaced, the exposed employee will most likely experience a rapid rise in body temperature and heart rate. The risk of heat injury is reduced when exposed employees periodically drink water in small amounts throughout the work period. 3.2 Acclimatization to heat: Acclimatization is acquired by working in hot environments for gradually increasing periods of time on a daily basis over a period of time. Acclimatization begins with the first exposure and is developed to 45-50 percent by the end of the first week. Full acclimatization (the ability to perform a maximum amount of work in the heat) is attained most quickly by gradually and progressively increasing work in the heat. Acclimatization period should be allowed regardless of individual physical condition. Supervisors should develop work schedules that provide for increasingly longer work periods alternating with appropriate rest periods. 3.3. Planning Work Schedules. Work schedules should be tailored to complete the mission while considering the climate and physical condition of the workers. Adequate supervisory control is critical in achieving maximum work output with minimum exposure to heat stress. Considerations for developing work schedules include Being Aware that the amount of heat produced by the body increases directly with increasing work. Therefore, reduction of workload decreases the total heat stress. Ensuring workloads and/or duration of physical exertion are less during the first days of exposure to heat and increasing workloads gradually to allow for acclimatization. Planning for and conducting heavy work during the cooler hours of the day such as early morning or late evening. Providing alternate work and rest periods. Increasing rest periods under severe heat conditions Providing shaded rest areas when possible and closely monitor employees for excessive sweating. Not requiring employees to stand in static positions for extended periods of time. Providing overhead cover/shades 3.4. Protective Clothing Protective clothing helps in protecting the body from heat stress. Employees should wear loose fitting, clothing that will not allow the heat to trap. Long sleeved shirts or coveralls should be worn for protection from the radiation of
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sun. 4. Monitoring for Signs and Symptoms of Heat Stress Supervisors, coworkers and employees themselves are responsible for monitoring for the signs and symptoms of heat-related disorders. See the above table for information on recognizing the signs and symptoms of impending heat stress. A supervisor or coworker is often in the best position to observe the onset of a heat-related disorder. When heat stress risks are present, supervisors should regularly check workers (by observation and questions) for signs and symptoms of heat stress. Take extra care to monitor those at high risk, such as employees who are older or overweight, employees who overexert themselves, and employees with chronic medical conditions including diabetes, heart or lung disease, thyroid disease or high blood pressure. Employees who take certain medications may also be at increased risk and need to check with their physician. If you need to work extended hours outdoors or within indoor environments with elevated temperatures, monitor yourself for the signs and symptoms of heat-related illness, such as taking your own pulse. Use a buddy system. When working in the heat, monitor the condition of your coworkers and have someone do the same for you. Supervisors should check to ensure that employees are self-monitoring, and ask for their determinations. 5. Employees Responsibility Employees who work outdoors or within indoor environments with elevated temperatures have the following responsibilities. Participate in your work units heat stress training. Learn the signs and symptoms of heat stress, as well as risk factors. Take extra care if you are at high risk. You may be at increased risk if you are older or overweight, you overexert, you have a chronic medical condition including diabetes, heart or lung disease, thyroid disease or high blood pressure. If you take medications, you should check with your doctor to see if you are at increased risk because of the effects of these medications. Follow the preventive measures listed in your work units HEMP Job Safety Analysis. Take time to acclimate to heat and humidity. A heat wave is stressful to your body. You will have a greater tolerance for heat if you limit physical activity until you become accustomed to it. Stay hydrated by drinking small amounts of cool water frequently, to relieve thirst and maintain adequate urine output.
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Wear appropriate clothing. Choose lightweight, light-colored, loose-fitting clothing. Pace yourself. Start slowly and pick up the pace gradually. Monitor yourself for the signs and symptoms of heat-related illness, described above. When working in the heat, monitor the condition of your co-workers. Ask your coworker to do the same for you. Promptly report to your supervisor any known or suspected unsafe conditions, or unsafe procedures.

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