Heat and Cold Stress Prevention Program

Outdoor Temperature and Clothing Action Levels
All other clothing	89 °F
Double-layer woven clothes including coveralls, jackets and sweatshirts	77 °F
Non-breathing clothes including vapor barrier clothing or PPE such as chemical resistant suits	52 °F

Outdoor work includes any employee assigned to work in the outdoor environment on a regular basis. This program does not apply to incidental exposure that exists when an employee is not required to perform a work activity outdoors for more than 15 minutes in any 60-minute period.

Program Responsibility

Supervisors are responsible for encouraging employees to frequently drink acceptable beverages (water or sports drinks without caffeine) to ensure hydration. Employees are responsible for monitoring their own personal factors for heat-related illness, including consumption of water or other acceptable beverages to ensure hydration.

Evaluating and Controlling Outdoor Heat Stress Factors

In addition to outdoor temperature, supervisors should evaluate other potential heat stress factors, including:

• Radiant heat (ex: reflection of heat from asphalt, or work in direct sunlight)

• Air movement (ex: wind blowing and temperature above 95 °F)

• Conductive heat (ex: operating orchard tractor for mowing)

• Workload activity and duration (ex: hand sawing, digging with a shovel)

• Personal protective equipment (ex: wearing a respirator or leathers and gloves for welding)

Supervisors should attempt to control outdoor heat stress factors when feasible. Controls to consider include:

• Taking breaks in a shaded area (building, canopy, and under trees)
• Starting the work shift early (when daylight begins) and ending the shift early and/or not working outside during the hottest part of the day
• Removing personal protective equipment during breaks
• Using cooling vests or headbands

Drinking Water

Sufficient quantity of potable drinking water will be provided and made accessible to employees. At least one quart of water per employee per hour will be available. Water can be found at the following locations:

• [LIST DRINKING WATER LOCATIONS]
• If a potable water source is not available at the worksite it is the supervisor’s responsibility to ensure that one quart of water per hour is available to each employee.

Procedures for Responding to Heat-Related Illnesses

Supervisors will respond to heat-related illness in a quick and safe manner. The table below outlines the potential types of heat-related illnesses, signs and symptoms, and specific first aid and emergency procedures. The information should be present at all work sites where outdoor work activities are conducted.

• Employees experiencing signs and symptoms of a heat-related illness are to cease work and report their condition to their supervisor.

• Employees experiencing sunburn, heat rash, or heat cramps will be monitored to determine whether medical attention is necessary.

• Emergency medical services will be called (911) when employees experience signs and symptoms of heat exhaustion or heat stroke.

Heat-Related Illness First Aid and Emergency Response Procedures
Heat-Related Illness	Signs and Symptoms	First Aid and Emergency Response Procedures
Sunburn	Red, hot skin Possibly blisters	Move to shade, loosen clothes Apply cool compress or water to burn Get medical evaluation if severe
Heat Rash	Red, itchy skin Bumpy skin Skin infection	Get out of sun Keep affected area dry
Heat Cramps	Muscle cramps or spasms Grasping the affected area Abnormal body posture	Drink water to hydrate body Rest in a cool, shaded area Massage affected muscles Get medical attention in cramps persist
Heat Exhaustion	High pulse rate Extreme sweating Pale face Insecure gait Headache Clammy and moist skin Weakness Fatigue Dizziness	CALL 911* Provide EMS with directions to worksite Move to shade and loosen clothing Start rapid cooling with fan, water mister, or ice packs Lay flat and elevate feet Drink small amounts of water to hydrate and cool body

*In remote areas, specific procedures might be required to move or transport employees to a place where they can be reached by emergency medical services.

Heat Illness Training

Employees who may be exposed to outdoor heat at or above the action levels should be trained on the following topics:

• Environmental factors that might contribute to the risk of heat-related illness (temperature, humidity, radiant heat, air movement, conductive heat sources, workload activity, and duration).

• Personal factors that may increase susceptibility to heat-related illness (age, degree acclimatization, medical conditions, drinking water, consuming alcohol, caffeine use, nicotine use, and use of medications that affect the body’s response to heat).

• The importance of removing heat retaining personal protective equipment, such as non-breathable chemical resistant clothing, during breaks.

• The importance of frequent drinking of small quantities of water.

• The importance of acclimatization.

• The different types and common signs and symptoms of heat-related illnesses.

• The procedure for immediately reporting signs and symptoms of heat-related illness in themselves or coworkers to their supervisor or person in charge.

Preventing Cold-Related Illnesses 

During the winter months, many workers face an additional occupational hazard—exposure to the cold. Some health problems can arise, including frostbite, trench foot, and hypothermia.

The Cold Environment

Environmental conditions that cause cold-related stresses are low temperature, cool high winds, dampness, and cold water.  Wind chill (temperature and wind velocity) is an important factor to evaluate when working outside. A dangerous situation of rapid heat loss may arise for any individual exposed to high winds and cold temperatures.

Other Major Risk Factors for Cold-Related Stresses

In addition to the cold environment, other major risk factors contributing to cold-related stresses include:

• Inadequate clothing or wet clothing.
• Drug use or certain medications may inhibit the body's response to cold or impair judgment.
• Gender: male death rates due to cold exposure are greater than the rates for females.
• Susceptibility increases with age.

Harmful Effects of Cold

Common harmful effects of cold include frostbite, trench foot, and general hypothermia. Frostbite occurs when skin tissue actually freezes and cell damage results. The freezing point of skin is approximately 30 °F, and wind chill can be a significant factor in accelerating the process. Fingers, toes, cheeks, nose, and ears are primarily affected.

FROSTBITE: The symptoms of frostbite include an uncomfortable sensation of coldness. There may be a tingling, stinging, or aching feeling followed by numbness. Initially the frostbitten area appears white and is cold to the touch. This is followed by heat, redness, and swelling. Occasionally a victim may not be aware of the frostbite.

Tissue damage can be mild and reversible or severe, resulting in scarring and tissue death. First aid includes treating affected areas with warm water at 102 to 110 °F.  Be careful to avoid rubbing frostbitten areas because this can lead to greater tissue injury.

TRENCH FOOT: Trench foot may be caused by long, continuous exposure to a wet and cold environment or actual immersion in water. Symptoms include a tingling and/or itching sensation, pain, and swelling. Blisters may form and be followed by death of skin tissue and ulceration.

First aid treatment for trench foot is similar to the treatment for frostbite and includes moving the victim to a warm area, treating the affected part with warm water (102-110 °F) or warm packs, arranging bed rest in a warm environment and obtaining medical assistance as soon as possible.

HYPOTHERMIA: General hypothermia is the progressive loss of body heat with prolonged exposure to cold. Most cases of hypothermia develop in air temperatures between 30 and 50 °F, but significant hypothermia can occur with air temperatures as high as 65 °F (particularly when clothing is wet) or in the water at 72 °F.

The first symptoms of hypothermia are uncontrollable shivering and feeling of cold. As the body's temperature continues to drop, an individual can become confused, careless, and disoriented. At this point a person may make little or no effort to avoid further exposure to the cold.  When the core body temperature falls below 86˚F, the body’s adaptive mechanisms for reducing heat loss become ineffective and death can occur.

Individuals experiencing mild hypothermia should be immediately moved to a warm, dry shelter. Further heat loss is minimized by removing wet clothing and applying warm blankets for insulation. Warm, nonalcoholic, caffeine-free drinks may be offered. More severe cases of hypothermia require intensive medical care.

Preventing Cold-Related Disorders

The following recommendations may help reduce the number of cold-related disorders that workers experience during the winter months.

Personal Protective Clothing

• Dress appropriately. Wear at least three layers:
  • An outer layer to break the wind and allow some ventilation (like Gore-Tex or nylon)
  • A middle layer of wool, down, or synthetic pile to absorb sweat and retain insulating properties when wet
  • An inner layer of cotton or synthetic weave to allow ventilation and escape of perspiration
• Keep a change of clothing available if work clothes get wet.
• Pay special attention to protecting feet, hands, head, and face. Keep the head covered (up to 40% of body heat can be lost when the head is exposed). 
• Wear footgear that protects against cold and dampness. Footgear should be insulated and fit comfortably when socks are layered.
• The employing department must provide extreme cold weather protective equipment. Extreme cold weather is defined as an equivalent chill temperature of -25 °F or lower. However, supervisors must consider employee requests to use extreme cold weather protective outerwear regardless of temperature.

Environmental Protection

• Protect hands, face, and feet from frostbite with an on-site source of heat. Air jets, radiant heaters, or contact warm plates may be employed.
• Provide a heated shelter for workers who experience prolonged exposure to the equivalent wind-chill temperature of 20 °F or less.
• Shield work areas from drafty or windy conditions.

Safe Work Practices

• Allow individuals to set their own pace and take extra work breaks when needed.
• Whenever possible, avoid activities that may cause heavy perspiration.
• Shift as many outdoor activities to the inside as feasible and, when working outside, select the warmest hours of the day.
• Minimize activities that reduce circulation, such as sitting or standing, in a cold environment for prolonged periods of time.
• Keep energy levels up and prevent dehydration by consuming warm, sweet, caffeine-free, nonalcoholic drinks and soup.
• Allow a period of adjustment to the cold before embarking on a full work schedule. Avoid working alone. In very cold weather use a buddy system.
• Seek warm shelter immediately following these symptoms: heavy shivering, an uncomfortable sensation of coldness, severe fatigue, drowsiness, or euphoria.

Worker Health and Education

Older workers, or those with certain medical problems, need to be extra alert about the effects of cold stress. Avoid using alcohol or drugs, which may impair judgment while working in a cold environment. Hypothermia commonly occurs in association with alcohol abuse. In addition to its effects on judgment, alcohol increases heat loss through vasodilation and may impair shivering. Educate new workers on the hazards of working in a cold environment. Prevent chapped skin by the frequent application of protective lotions. Stay in good physical condition.

Supervisor Responsibility

• Determine whether employees will be working in cold weather conditions.
• Ensure that employees are equipped with and wear protective outerwear when necessary.
• Implement work/warm-up schedules when indicated by the equivalent chill temperature chart.
• Upon observing, or being notified of, an employee experiencing the initial symptoms of frostbite or hypothermia, the supervisor is to ensure that the employee is moved to a warm location. If symptoms worsen or additional symptoms appear, the supervisor should ensure that the employee is examined by a medical professional.

Employee Responsibility

• Wear department provided protective outerwear or equivalent personal protective outerwear when required to work in cold weather conditions.
• An employee experiencing any of the initial symptoms of frostbite or hypothermia must immediately move to a warm location and notify his/her supervisor of the symptoms. If symptoms worsen or additional symptoms appear, the employee must immediately seek medical attention.

Heat and Cold Stress Forms

NOAA Wind Chill Chart

http://www.crh.noaa.gov/ddc/?n=windchill#New