Heat Stress Management

Management of Heat Disorders

Heat disorders are mild to serious reactions to high environment temperature due to inadequate or inappropriate responses of heatregulating mechanisms. Exposure to high ambient temperature without efficient heat loss may lead to heat cramps, heatstroke, or heat exhaustion. Acute or prolonged exposure to heat with excessive sweating uncompensated by fluid intake leads to dehydration, sodium and potassium depletion, and hypovolemia. Associated vomiting and diarrhea contribute to fluid loss. Heatstroke and heat exhaustion both occur in hot, humid environments, but they are markedly different disorders. Resources required: the recommended shelters, cloths, meals, fluids and medicines should be provided to the personnel. A campaign information should be in place, including posters, and documentation. Training, physical conditioning and acclimatization programs should be in place.

Factors influencing the body’s heat-regulating mechanisms Environmental as well as physiological factors influence the body’s heat-regulating mechanisms. Environmental Factors: Ambient air temperature: Ambient air temperature dictates the direction of heat flow from or to the body. When air temperatures are high, the direction of heat flow is to the body, and heat can only be dissipated by sweating where the heat is carried away by sweat evaporation at the skin surface. Wind velocity: Air currents carry body heat away. The higher the velocity of these currents, the faster the heat loss.

Humidity: Evaporation, the most important source of heat loss, depends on relative humidity: The higher the humidity, the less efficient the heat loss. Therefore, high ambient humidity (which decreases the cooling effect of sweating) and prolonged strenuous exertion (which increases heat production by muscle) increase the risk of developing heat disorders. Radiant heat: Radiant heat is the heat produced by the reflective energy of the sun or equipment in close proximity to a human body. The radiated heat is absorbed into the surrounding air or directly into the body. In either case the body’s ability to cool itself is hampered.

Physiological Factors: Predisposing factors that may increase susceptibility to heat disorders are: * Previous history of heat illness (exhaustion, stroke or cramps). * Personnel suffering from or recovering from an acute or chronic disease or debility. * Old age personnel are more susceptible to heat disorders. * Poor physical conditioning. * Obesity interferes with the heat regulatory mechanism and causes the individual to expend more energy to accomplish a given amount of work. * Fatigue, physical and mental weariness can cause a lot of concern and result in a failure to take proper precautions against heat injuries.

* Dehydration due to vomiting, diarrhea or insufficient water intake predisposes to heat disorders, as individual’s fluid output is greater than fluid intake. * Personnel suffering from skin trauma due to sunburn, heat rash or other dermatological malady. The body’s heat regulatory mechanism is hampered at the skin surface. * Chronic alcoholism, alcohol should not be consumed for 24 hours prior to heat stress. * Certain drugs (e.g., anticholinergics, antihistamines, phenothiazines, decongestants, numerous psychoactive drugs, immunizing agents, alcohol, cocaine…)interfere with the body’s heat regulatory mechanism. * Sickling of blood cells impairs circulation and increases risk of injury. Persons with sickle cell trait should be advised of their risk and preventive measures.

Prevention The successful prevention of heat injuries depends largely on education of personnel, especially supervisory personnel. Equally important is the development of procedures to alert individuals to the existence of dangerous heat stress levels once temperatures exceed 40 C.

“Always remember that prevention is better than cure.”

RESPONSIBILITIES A. Responsibilities of Project/Site Management Project /Site Management is in charge of ensuring that this Management of Heat Stress has been applied and respected by all personnel and mainly those working in extreme heat climates where the temperatures can exceed 40 C. B. Responsibilities of HSE Representative HSE Representative is in charge of insuring that this approach has been explained and well understood by all the personnel and mainly those working in extreme heat climates where the temperatures can exceed 40 C. And also that this approach has been applied and respected by all the personnel and mainly those working in extreme heat climates where the temperatures can exceed 40 C. C. Responsibilities of Medical Doctor/Nurse The Medical Doctor/Nurse is in charge of application of this Heat Stress Management.

The application of measures to reduce both the severity and duration of exposure and adoption of techniques to increase the resistance of exposed persons. These techniques are: Using common sense is best. Selection of personnel: * Employ personnel physically fit to work in such hot environment. Avoid direct sunlight: * Stay in the shade when you can. * Shelter under shades, draperies, awnings, or louvers. * During periods of extreme heat, stay indoors as much as possible out of the sunshine. Meals and water: * Eat well-balanced, light meals before, during and after any outdoors strenous activity. * Drink plenty of water regularly before, during and after any outdoors strenous activity. Persons who have epilepsy or heart, kidney, or liver disease; are on fluid-restrictive diets; or have a problem with fluid retention should consult a doctor before increasing liquid intake.

Alcohol and caffeine: * Limit intake of alcohol beverages and caffeine. Although beer and alcohol beverages appear to satisfy thirst, they actually cause further body dehydration. Cloths: * In a very hot environment or in an inadequately ventilated space heavy insulating clothing should not be worn. Wear light-colored, loose- fitting, open-weaved clothes that cover as much skin as possible and that reflects heat and sunlight and helps maintain normal body temperature. Clothing should be loose fitting, especially at the neck, arms, waist and lower legs, to permit circulation of air. * Protect face and head by wearing a wide-brimmed hat. * In extreme heat, avoid activities that require you to wear a helmet. Acclimatization: * Allow your body to get acclimated to hot temperatures for at least 2 or 3 days. * Increase the amount of time you spend outdoors and your activity everyday little by little.

Avoid sunburn: * Sunburn slows the skin’s ability to cool itself, use a sunscreen lotion with high SPF (sun protection factor) rating. Avoid extreme temperature changes: * A cool shower immediately after coming in from hot temperatures can result in hypothermia, particularly for elderly and very young people. Work schedules: * Strenuous exertion in a very hot environment or in an inadequately ventilated space should be avoided. * Try to schedule strenuous activities during the cooler hours of the day, early in the morning or late in the evening, avoid heavy outdoor activity between 10 AM and 6 PM, when sun is the hottest. If exertion a hot environment is unavoidable: * Fluid and electrolytes should be replaced by frequently drinking fluids slightly salty to taste. * Wearing open mesh clothing or using fans should facilitate evaporation, which helps the skin cool. * Individuals should be instructed to note the color of their urine,

Heat-related injuries fall into three major categories: Heat cramps Heat exhaustion Heatstroke

Heat cramps are muscular pains and spasms that occur when the body loses electrolytes during profuse sweating or when inadequate electrolytes are taken into the body. They usually begin in the arms, legs or abdomen, and often precede heat exhaustion.

Treatment for heat cramps is to rest in the shade, get near a fan, spray the person with water and massage the cramp.

Heat exhaustion is a medical emergency. When a person is suffering from heat exhaustion, they will perspire profusely and most likely will be pale. It is best treated by taking the patient to a cool place, applying cool compresses, elevating the feet and giving the patient fluids.

Signs & symptoms of Heat Exhaustion Normal, low, or only slightly elevated body temperature. Cool, clammy, pale skin. Sweating. Dry mouth. Thirst. Fatigue. Weakness. Feeling dizzy. Headache. Nausea. Vomiting can occur. Muscle cramps. Weak or rapid pulse.

Heat stroke is the worst heat-related injury. The brain has lost its ability to regulate body temperature. The patient will be hot, reddish and warm to the touch. Their temperature will be markedly high and there will be no perspiration.

Signs & symptoms of Heat Stroke These signs and symptoms can occur suddenly with little warning: Very high temperature (104ºF or higher). Hot, dry, red skin. No sweating. Deep breathing and fast pulse. Then shallow breathing and weak pulse. Confusion. Hallucinations. Convulsions. Loss of consciousness. Do not attempt to treat a case of heat stroke at home, but you can help while waiting for medical assistance to arrive.

Here’s what to do: The emergency care of heatstroke is to cool the body as quickly as possible. One of the best methods for cooling the body during a heat emergency is to wrap the patient in cool, wet sheets. Move the person to a cooler environment, or place him or her in a cool bath of water (as long as he or she is conscious and can be attended continuously). Alternatively, moisten the skin with lukewarm water and use a fan to blow cool air across the skin. Give cool beverages by mouth only if the person has a normal mental state and can tolerate it.

Saipem corporate procedure of the Heat stroke prophylaxis, treatment depends from medic on site (kind of medicine and dose). Approved treatment: POLASE tablets / Potassio+Magnesio raceaspartato or -the HYDRALYTE (electrolyte replacement drink) Or - DEXTORSE mineral salts tab. Or you can buy any kind of mineral salts tab. The dose of medicine depends on the degree and time of heat exposure: and of course from condition of employee. Please note: it is not for health if it is over dose! The kidney stones could be made by a lots of mineral salts in human blood (as for example).

Summer is the perfect time to get outdoors and enjoy the sunshine! But the summer sun and heat can take a major toll on your health, so don’t let a heat-related illness ruin your day. Learn how you can protect yourself from the sun so you can have a happy, healthy and safe summer.

Prepared by: Joseph Consular Medical Department Saipem Spa, Sharjah Branch Tel. No. +97165284140, Exr. 266 Mobile No. +971502703856 Email: [email protected]