Heat Illness Prevention Program

The Heat Illness Prevention Standard (CCR, Title 8, Section 3395(link is external)) requires all employers with outdoor worksites to take certain steps to prevent heat related illness. Heat related illness is a serious medical condition that results when the body is unable to cool itself sufficiently through sweating. Both personal and environmental factors can contribute to the likelihood of developing heat related illnesses which includes heat stress, heat exhaustion, heat cramps, heat syncope (fainting) and ultimately, heat stroke. The purpose of this program is to teach supervisors and employees how to reduce the risk of heat related illness, and respond properly should heat related illness occur.

Department Heads and Chairs

• Providing the necessary resources to ensure the health and safety of their employees;
• Identifying individuals as supervisors and ensuring they are trained on their health and safety responsibilities;
• Ensuring departmental compliance with campus health and safety policies and procedures;
• Ensuring hazards workplace hazards are identified and controlled.

Managers, Supervisors, and Principal Investigators

• Ensuring their units understand and comply with the requirements of this program;
• Ensuring that there is a written Heat Illness Prevention Plan that covers each outdoor worksite they are responsible for (see Attachment B&C);
• Developing and implementing procedures to comply with the requirement of this program as needed;
• Ensuring employees have completed documented Heat Illness Prevention training;
• Being aware of risk factors that contribute to heat illness;
• Reducing the risk of heat illness by taking special precautions when necessary;
• Being alert for the signs and symptoms of heat illness in employees;
• Allowing employees acclimate to working in hot conditions;
• Making sure employees working in hot conditions are accounted for at the end of the work shift;
• Ensuring employees have access to potable drinking water at all times;
• Ensuring employees have the necessary Personal Protective Equipment to reduce heat stress (sun hats, light colored clothing, etc.) when needed;
• Monitoring weather conditions and implement High-heat Procedures when temperatures equal or exceed 95 degrees Fahrenheit;
• Ensuring procedures for contacting emergency medical services are in place, and if necessary, arrange for the transportation of employees to a point where they can be reached by an emergency medical provider;
• Knowing what to do and how to summon emergency responders should a heat illness emergency occur.

Employees, Students and Volunteers

• Understanding and complying with campus health and safety policies and procedures;
• Notifying their supervisor or SRM about any hazardous conditions observed on the worksite;
• Informing their supervisors of any factors that may increase their risk of heat related illness;
• Reporting the signs or symptoms of heat illness in themselves, or others, to their supervisor or SRM immediately.

Hazard Assessment

Types of Heat Illness and First Aid There are several types of heat-related illness. The following sections will explain the symptoms, causes and first aid procedures for each type of heat-related illness. All signs or symptoms of heat illness should be reported to a supervisor immediately. If a supervisor observes, or any employee reports, any signs or symptoms of heat illness in an employee, the supervisor shall take immediate action commensurate with the severity of the illness. If the signs or symptoms are indicators of severe heat illness (such as, but not limited to, decreased level of consciousness, staggering, vomiting, disorientation, irrational behavior or convulsions), emergency response procedures shall be implemented. An employee exhibiting signs or symptoms of heat illness shall be monitored and shall not be left alone or sent home without being offered onsite first aid and/or being provided with emergency medical services.

Heat Stroke

Heat stroke is the most serious heat-related disorder. It occurs when the body becomes unable to control its temperature; the body's temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. When heat stroke occurs, the body temperature can rise to 106 degrees Fahrenheit or higher within 10 to 15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not given.

Heat Stroke Symptoms:

• Hot, dry skin or profuse sweating
• Hallucinations
• Chills
• Throbbing headache
• High body temperature
• Confusion/dizziness
• Slurred speech Heat Stroke First Aid:
• Contact emergency medical services and notify supervisor. Move the individual to a cool, shaded or air conditioned area.
• Cool the individual using methods such as:
  • Loosening or removing clothing
  • Soaking their clothes with water.
  • Spraying, sponging, or showering them with water.
  • Fanning their body

Heat Exhaustion

Heat exhaustion is the body's response to an excessive loss of water and salt, usually through excessive sweating. Workers most prone to heat exhaustion are those that are elderly, have high blood pressure, and those working in a hot environment.

Heat Exhaustion Symptoms:

• Heavy sweating
• Extreme weakness or fatigue
• Dizziness, confusion
• Nausea
• Clammy, moist skin
• Pale or flushed complexion
• Muscle cramps
• Slightly elevated body temperature
• Fast and shallow breathing

Heat Exhaustion First Aid:

• Contact emergency medical services and notify supervisor.
• Move individual to a cool, shaded or air conditioned area and allow them to rest.
• Encourage individual to drink water or other cool, nonalcoholic and non-caffeinated beverages.
• Cool the individual using methods such as:
  • Loosening or removing clothing
  • Soaking their clothes with water.
  • Spraying, sponging, or showering them with water.
  • Fanning their body.

Heat Syncope

Heat syncope is a fainting (syncope) episode or dizziness that usually occurs with prolonged standing or sudden rising from a sitting or lying position. Factors that may contribute to heat syncope include dehydration and lack of acclimatization.

Heat Syncope Symptoms:

• Light-headedness
• Dizziness
• Fainting Heat Syncope First Aid:
• Contact emergency medical services and notify supervisor.
• Have individual sit or lie down in a cool, shaded or air conditioned area and allow them to rest. · Encourage individual to drink water or other cool, nonalcoholic and non-caffeinated beverages

Heat Cramps

Heat cramps usually affect workers who sweat a lot during strenuous activity. This sweating depletes the body's salt and moisture levels. Low salt levels in muscles causes painful cramps. Heat cramps may also be a symptom of heat exhaustion.

Heat Cram Symptoms:

• Muscle pain or spasms usually in the abdomen, arms, or legs.

• Heat Cramp First Aid:
• Stop all activity, and sit in a cool place.
• Drink clear juice or a sports beverage.
• Do not return to strenuous work for a few hours after the cramps subside because further exertion may lead to heat exhaustion or heat stroke.

· Seek medical attention if any of the following apply:

• The worker has heart problems.
• The worker is on a low-sodium diet.
• The cramps do not subside within one hour.

Heat Rash

Heat rash occurs when sweat ducts become clogged and the sweat can't get to the surface of the skin. Instead, it becomes trapped beneath the skin's surface causing a mild inflammation or rash.

Heat Rash Symptoms:

• Heat rash looks like a red cluster of pimples or small blisters.
• It is more likely to occur on the neck and upper chest, in the groin, under the breasts, and in elbow creases.

Heat Rash First Aid:

• Work in a cooler, less humid environment when possible.
• Keep the affected area dry.
• Dusting powder may be used to increase comfort.

Personal and Environmental Risk Factors

There are a number of factors that can increase the likelihood of an individual experiencing heat related illness. Often heat illness is a result of a combination of environmental and personal risk factors. Environmental Risk Factors Environmental risk factors are working conditions that increase the likelihood of a person experiencing heat related illness.

They include:

• Warm temperatures
• High humidity
• Direct exposure to the sun or other heat sources
• Limited air movement

Personal Risk Factors

Personal factors affect how well an individual responds to heat. They include: Age, weight, and physical condition

• Degree of acclimatization
• Consumption of water, alcohol, drugs and caffeine · Use of medications that affect tolerance to heat

Job Related Risk Factors

An individual's job duties may increase the likelihood of experiencing heat related illness, such as:

• Physical exertion and duration
• Protective clothing and protective equipment worn by employees

At Risk Employees Although Cal Maritime typically enjoys a mild climate, there are times when environmental conditions may increase the risk of heat related illness. The following are examples of groups of employees who may be susceptible to these conditions:

• Athletics Staff
• Delivery Personnel
• Emergency Response Personnel
• Events Staff
• Facilities Management Employees
• Field Researchers
• Groundskeepers
• Hazardous Materials Workers
• Kitchen Staff
• Housing Services Employees
• Parking Services Employees
• Police Officers  
• Other individuals not listed who work outdoors, or in indoor areas where heat stress is likely to occur (kitchens, boiler rooms, etc.).

Heat Illness Prevention Procedures

Departments and their supervisors are responsible for developing, implementing, and maintaining, effective procedures to reduce the risk of heat related illness. These procedures shall be in writing and include specific heat illness prevention measures and emergency response procedures for each worksite location. Supervisors and employees should review their procedures on a regular basis, and update them as needed. The Department of Safety & Risk Management is available, upon request, to help evaluate job tasks, procedures and environmental conditions

Heat Illness Prevention Plan

A Heat Illness Prevention Plan shall be developed and implemented at each outdoor worksite, and indoor worksites, where it could be reasonably anticipated that heat related illness could occur. The plan shall be in writing in both English and the language understood by the majority of the employees and shall be made available at the worksite to employees and to representatives of the Division upon request.

The Heat Illness Prevention Plan at a minimum shall contain:

• · Procedures for the provision of water and access to shade;
• · Acclimatization procedures;
• · Emergency Response Procedures;
• · High heat procedures, where applicable.

To assist Departments and Supervisors in meeting these requirements SRM has developed the Cal Maritime Campus Heat Illness Prevention Plan which covers most on-campus worksites, and a Worksite Specific Heat Illness Prevention Plan Worksheet for off-campus locations and other locations not adequately covered by the campus plan. Supervisors must ensure that there is a written Heat Illness Prevention Plan for each worksite under their responsibility, and employees covered by the plan have review it and are trained on its procedures prior to commencing outdoor work.

Heat Illness Prevention Measures

Emergency Response Procedures

• How effective communication by voice, observation, or electronic means will be maintained so that employees at the work site can contact a supervisor or emergency medical services when necessary. An electronic device, such as a cell phone or text messaging device, may be used for this purpose only if reception in the area is reliable.
• If an electronic device will not furnish reliable communication in the work area, the employer will ensure a means of summoning emergency medical services.
• How to respond to signs and symptoms of possible heat illness, including but not limited to first aid measures and how emergency medical services will be provided.
• How to contact emergency medical services and, if necessary, how employees will be transported to a place where they can be reached by an emergency medical provider.
• How in the event of an emergency, clear and precise directions to the work site can and will be provided as needed to emergency responders.

In non-remote areas throughout the United States, emergency medical services are generally available by calling 911. Supervisors are to ensure that employees are able to provide clear concise directions to their worksite. In remote field locations, developing procedures for emergency medical services may require extensive planning, and supervisors must ensure employees are informed of exactly how and where medical attention may be received. Always make sure employees have communication means and knowledge of how to guide emergency services to their location.

If a supervisor observes, or any employee reports, any signs or symptoms of heat illness in an employee, the supervisor shall take immediate action commensurate with the severity of the illness. If the signs or symptoms are indicators of severe heat illness (such as, but not limited to, decreased level of consciousness, staggering, vomiting, disorientation, irrational behavior or convulsions), emergency response procedures shall be implemented. An employee exhibiting signs or symptoms of heat illness shall be monitored and shall not be left alone or sent home without being offered onsite first aid and/or being provided with emergency medical services. Supervisors must reiterate to all employees the importance of immediately reporting any symptoms or signs of heat illness in themselves or co-workers and remind employees what to do in case emergency medical treatment is needed.

• Dial 911 for emergency medical help;
• Tell the dispatcher this is a heat related illness;
• Provide information on the exact location of the incident using maps and building information which are readily displayed around campus if necessary.
• Provide first aid to victim until emergency responders arrive
• Notify your supervisor and contact Cal Maritime Workers' Compensation in the HR Department.

High-heat Procedures

• Agriculture
• Construction
• Landscaping
• Oil and gas extraction
• Transportation or delivery of agricultural products, construction materials or other heavy materials (e.g. furniture, lumber, freight, cargo, cabinets, industrial or commercial materials), except for employment that consists of operating an air-conditioned vehicle and does not include loading or unloading.

Supervisors of employees that fall under the categories list above shall implement high-heat procedures when the temperature equals or exceeds 95 degrees Fahrenheit. These procedures must include the following to the extent practicable:

• Scheduling work during the cooler hours of the day, or if possible postponing work until ambient temperatures decrease.
• Ensuring that effective communication by voice, observation, or electronic means is maintained so that employees at the work site can contact a supervisor when necessary. An electronic device, such as a cell phone or text messaging device, may be used for this purpose only if reception in the area is reliable.
• Remind employees throughout the work shift to drink plenty of water.
• Designating one or more employees on each worksite as authorized to call for emergency medical services, and allowing other employees to call for emergency services when no designated employee is available.
• Pre-shift meetings before the commencement of work to review the high heat procedures, encourage employees to drink plenty of water, and remind employees of their right to take a cool-down rest when necessary.
• Observing employees for alertness and signs or symptoms of heat illness. The employer shall ensure effective employee observation/monitoring by implementing one or more of the following:​
• a. Supervisor or designee observation of 20 or fewer employees, or
  b. Mandatory buddy system, or
  c. Regular communication with sole employee such as by radio or cellular phone, or
  d. Other effective means of observation.
• For employees employed in agriculture, the following shall also apply: When temperatures reach 95 degrees or above, the employer shall ensure that the employee takes a minimum ten minute net preventative cool-down rest period every two hours. The preventative cool-down rest period required by this paragraph may be provided concurrently with any other meal or rest period required by Industrial Welfare Commission Order No. 14 (8 CCR 11140) if the timing of the preventative cool-down rest period coincides with a required meal or rest period thus resulting in no additional preventative cool-down rest period required in an eight hour workday. If the workday will extend beyond eight hours, then an additional preventative cool-down rest period will be required at the conclusion of the eighth hour of work; and if the workday extends beyond ten hours, then another preventative cool-down rest period will be required at the conclusion of the tenth hour and so on. For purposes of this section, preventative cool-down rest period has the same meaning as "recovery period" in Labor Code Section 226.7(a)

Departments shall ensure effective documented Heat Illness Prevention Training meeting the requirements below is provided to all employees, and supervisors of employees, who perform outdoor work, or indoor work where heat related illness could reasonably be anticipated to occur.

• The Department's procedures for complying with the requirements of this standard, including, but not limited to, the Department's responsibility to provide water, shade, cool-down rests, and access to first aid as well as the employees' right to exercise their rights under this standard without retaliation;
• The different types of heat illness, and the common signs and symptoms of heat illness, and appropriate first aid and/or emergency responses to the different types of heat illness, and in addition, that heat illness may progress quickly from mild symptoms and signs to serious and life threatening illness;
• The environmental and personal risk factors for heat illness, as well as the added burden of heat load on the body caused by exertion, clothing, and personal protective equipment;
• The importance of frequent consumption of small quantities of water, up to 4 cups per hour, when the work environment is hot and employees are likely to be sweating more than usual in the performance of their duties;
• Procedures for the provision of water and access to shade;
• The concept, importance, and methods of acclimatization.
• The importance of immediately reporting the symptoms or signs of heat illness in themselves, or in co-workers;
• The Department's procedures for responding to signs or symptoms of possible heat illness, including how emergency medical services will be provided should they become necessary;
• Procedures for ensuring that, in the event of an emergency, clear and precise directions to the work site can and will be provided as needed to emergency responders. These procedures shall include designating a person to be available to ensure that emergency procedures are invoked when appropriate.
• Special procedures for contacting emergency medical services, and if necessary, for transporting employees to a point where they can be reached by an emergency medical service provider;
• High heat procedures, if applicable.

Additional Supervisor Heat Illness Training

• Supervisory requirements and responsibilities under the Cal Maritime Heat Illness Prevention Program and Heat Illness Prevention Standard;
• The procedures the supervisor is to follow when an employee exhibits symptoms consistent with possible heat illness, including emergency response procedures;
• How to monitor weather reports and how to respond to hot weather advisories.

Other Resources

• Cal/OSHA Heat Illness Prevention Standard (CCR, Title 8, Section 3395)(link is external)
• California Division of Occupational Safety and Health (DOSH) Heat Illness Prevention Information(link is external)
• NOAA Heat Wave Information(link is external) and Heat Index Chart