Toolbox Talk: Heat stress isn’t cool

• • How do we understand heat stress?
  • What can you do as a plumber to prevent heatstroke and heat stress from affecting you and your employees
  • Excessive exposure to heat can cause a range of different heat related illnesses including heat rash, cramps, heat exhaustion and heat stroke

As we move into the summer months, the risk of heatstroke for plumbers is very high indeed. This is because a lot of plumbing work is done out of doors – on the outside of buildings or perhaps on construction sites, where plumbers may be working without any roof covering. A lot of work obviously is also done indoors – in walls or in ceilings – but just because one is out of the sun doesn’t necessarily mean that heat stroke is less of a possibility. In fact, sometimes it is more of a possibility in an enclosed space.

This is because some of these working areas are unfinished with no proper ventilation yet, whether it be inside a ceiling or inside a confined space. And heat is also generated by tools, by workers breathing, building up heat like a sauna and creating the potential for heatstroke.

What can we do to prevent it? How do we understand heat stress? And what can you do as a plumber to prevent heatstroke and heat stress from affecting you and your employees. For one thing, excessive exposure to heat can cause a range of different heat related illnesses including heat rash, cramps, heat exhaustion, and heat stroke. The latter is one of the most dangerous ailments because heat stroke is a condition caused by your body overheating as soon as your body’s temperature gets to 40 degrees or higher.

The condition is most common in the summer months, which we’ve now moved into. Plumbers out on the road will be doing so in temperatures of 40, 41 and 42 degrees Celsius – and that is a lot of heat to be also doing physical exertion making it even more dangerous. Heat stroke often requires emergency medical treatment and if untreated can damage your brain, your heart, your kidneys and your muscles. The damage will worsen the longer the treatment is delayed, including the risk of serious complications and there is even the potential to cause a person’s death. While this is unlikely, if death is going to happen at all it is most likely to happen during these next few hot months.

What do we need to do?

We need to ensure that we know and understand what is heatstroke. This includes how you can prevent heatstroke and what types of procedures do you have in place to prevent it from occurring and affecting yourself or your employees.

 

For one thing, you need to know the symptoms of heatstroke. If you are working in a hot environment and noticed that the sun is beating down, even if you don’t have a temperature gauge, just look on an app or ask the safety officer or supervisor on site to determine what the temperature is. Symptoms include:

• • Tiredness: A tiredness that is not a normal tiredness from working hard
  • Dizziness
  • Headache
  • Feeling sick or nauseous
  • Excessive sweating, and skin becoming pale and clammy or if you start getting a heat rash
  • A change in skin colour, though this can be harder to see on darker skinned persons
  • Cramps in your arms, legs or your stomach
  • If you have faster breathing or a faster heart rate
  • Perhaps you have a higher temperature. Following Covid-19 we often have tools on site to check a person’s temperatures, and so perhaps this may be already available
  • Being very thirsty
  • Weakness

If you have just one of these, it doesn’t mean you definitely have heat stroke, as some of them are similar to symptoms of Covid-19 and other ailments. They could also be symptoms of fatigue, overwork or stress. However, if the environment is creating any one of these symptoms, obviously then it is not an optimal environment. And if you are working in the sun doing physical exertion during this hot season there is a high possibility that it could turn into heatstroke. So be conscious and look out for these symptoms, making sure that you try to prevent them.

Treatment

Most importantly, you want to ensure you have procedures in place for heat stroke, heat stress, or any type of emergency situation as part of your emergency management plan. As this will generally fall under the category of medical emergencies, you are going to need to call upon professional assistance. If a medical emergency happens – and heatstroke is one of those medical emergencies – you must have a procedure in place to deal with them.

The first action is to call the emergency services. Remember, heat stroke requires medical attention because it could have damaged internal organs. And if that is the case, there could be complications later on, or even the possibility of a person dying because of heatstroke. Then you must remove excess clothing – not ordinary clothing but excess clothes. Let’s say the person is in a cordoned off area where no work is going to be taking place because of the emergency situation currently happening. The First Aider will address the scene, ensuring it is safe to assist this person and then perhaps remove extra layers of clothing retaining heat on that person’s body, such as a high visibility vest or a reflective vest or jacket. If they have a shirt on underneath, you can remove the jacket which is excess clothing but not remove the shirt and expose the person.

Then try and cool the person down with water or fanning the person to try keep them cool. Most particularly, you don’t want to leave the individual in direct sunlight – but rather wherever the person is placed make sure they are in as cool a place as possible. If the person is conscious, you can give them small amounts of water to drink in the case of heatstroke – but please do not do this if you are not a First Aider. First Aiders must make sure they have been trained to understand how this employee is going to be affected by heatstroke. First Aiders are not allowed to put anything in that person’s mouth – if they are conscious, you hand them water and let them drink it.

To keep them cool, you can use a wet towel over their forehead, using cool running water on a wet towel so it cools down the head and perhaps brings the body temperature down as well. You can also put the wet towel around the back of the neck in order to bring down the body temperature. Also elevate the feet. Then let them rest until professional help arrives.

When it comes to any type of treatment, you need to be trained, according to OHS regulations. For one to five employees on a site, you need to have a first aid box. For six to 10 employees on a site, you need to have a qualified First Aider. But here’s a dilemma: if you have only five people on site, and the law says you do not have to have a First Aider, how would you know how to use the items in the first aid box? It would be logical if you worked in a high-risk environment but have only five people, to nonetheless have a qualified First Aider. This is an instance where the minimum compliance in terms of the law is inadequate – saying that you only need to have a qualified First Aider once you’ve reached 10 employees.

Knowing the degree of danger and the risk assessment of a site, some clients of a construction team may require that – even though you have five employees – you must still have a First Aider on site. They are 100% allowed to ask that based on the degree of risk and danger you are facing on that site.

Remember, the law states only the minimum requirement, and you should always strive to attain a higher standard of health and safety. It is quite possible that the client changes their mind of the safety specification from when you first started working to a few weeks later.

This is governed by two factors:

• • Firstly, are they asking for it for the correct reason?
  • Secondly, does the reason dictate that the necessity of a First Aider will mitigate risks?

Say the client says to you at the beginning of the project, you don’t need a health and safety First Aider as you only have five employees and so only need a first aid box. But two weeks later, they change their tune, saying you now have to have a First Aider – meaning you have to outlay money for training and give them time off work. Your first question should be, what has changed that allowed the client to ask for this? Has there been an incident? Did somebody get hurt? Has your risk increased? What was the scope of work? Perhaps you were working on the floor when you started working, but now the work has escalated requiring scaffolding work on a roof and working with mobile elevated working platforms. Then the degree of risk has changed and become a lot higher.

In that instance, they are allowed to ask for additional health and safety standards. But according to contractual law, this is a change of contract and affects your procurement meaning you will need to claim a change of scope. It’s a change of contract and you will need to requote for the work. You are allowed to change your quote to include the items that you unexpectedly require for site. The client cannot then argue, ‘It’s a legal requirement, you just have to have it’. That would be incorrect – it is not a legal requirement but over and above the legal requirement. Therefore, you’re not saying you don’t want to do it, but rather that the parameters have been changed by the client and that it is fair to adjust your quote as well.

Preventing heat stress

What can you do to prevent heat stress happening to your team? The first thing is to know the signs and symptoms so as to determine whether it’s heat stress.

If you see somebody acting groggy, looking a little bit dizzy, not feeling very well, looking a bit nauseous, weak and tired, or sweating a lot – you could probably determine that something is wrong even if you’re not 100% certain what it is. None of us can determine this for sure, because we’re not trained for that. But we can learn and understand the symptoms or the signs that could be a potential for heat stress. So first take a good look and see if there is a possibility of it – and if so act immediately to isolate that person and get them the attention that they need, preferably from a First Aider.

Then also don’t forget to monitor yourself: are you also feeling a bit dehydrated; have you had enough clean running (or bottled) water to drink? Refrain from drinking too much sugary drinks, or excessive alcohol, both of which will dehydrate you even more. It is water that will rehydrate your body and prevent heat stress. Be diligent about doing this if you see any signs of heat stress in yourself or in any anyone else – and treat it immediately.

Try and block out direct heat sources with, for instance, hard hats that come with sun visors or a brim around the hat to give a little more shade. There are different types of PPE that will help you to keep shaded, as well as using an approved sunscreen, perhaps recommended by your medical practitioner.

Try work in shady areas by planning your day to work in direct sunlight only in the earlier hours of the day or the later afternoon when the sun is not strongest. In the middle part of the day, between 11am and 2pm rather do work that can be done in the shade as far as possible according to your scope of work. It means proper daily planning for each job.

Facilities regulations tell us that any working environment must be well ventilated, either by mechanical or natural means. ‘Natural’ means airflow in and around the building. If there is no natural airflow, then it requires mechanical ventilation such as an indoor cooling fan or air conditioner. Remember, you are just as likely to get heat stress indoors as you are outdoors depending on the situation that you’re working in.

Sunburn

Along with heatstroke, sunburn is another very dangerous effect that is common during the summer months – less so at work as when you are lounging around the pool at home or taking a holiday with your family. When it comes to occupational health and safety, we tend to focus on the worksite – but even when you go home, you and your family are at high risk of sunburn even at your own home.

Sunburn is not only painful it is dangerous and comes with consequences because sunburn causes DNA damage to the skin, accelerates skin aging and increases your lifetime risk of skin cancer. Sustaining five or more sunburns in your youth increases lifetime melanoma risk by 80%. South Africans typically have had more than that because almost every December we get sunburned on the beach.

• • Avoid the sun during your peak hours if at all possible, between 10 and 2
  • Seek shade
  • Wear clothing with UPF (ultraviolet protection factor) protection 50+ helps block 98%
  • Wear sunglasses with UV protection
  • Wear a wide brimmed hat
  • Always apply sunscreen at least 15 minutes before you go outdoors even on a cloudy day. The sun could also have a potential to burn you then
  • Keep your pets safe, as heatstroke is also a very serious condition for them. Many cases of heatstroke in dogs occur during exercise, but also by being trapped in a hot parked car.

By Eamonn Ryan based on an IOPSA Toolbox Talk presentation by Chris Coetzee – director of OHS Savvy Consulting (Pty) Ltd, HSE Member of IOPSA and Technical Member of SAIOSH