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Weekend Doctor: Preventing heat illness

By Jason Wartgow, APRN-CNP
Certified Nurse Practitioner, McComb Family Practice

The body normally cools itself by sweating. During hot weather, especially in high humidity, sweating isn’t enough. Body temperature can rise to dangerous levels if precautions are not taken. Workers exposed to hot and humid conditions are at risk of heat illness, particularly to those doing heavy work tasks or using bulky protective clothing and equipment. Factors that increase the likelihood of heat exhaustion include intense/strenuous work, diabetes or hyperglycemia, drug abuse, heavy/long-term alcohol use, tobacco use, obesity, medications for certain illnesses (depression, insomnia, allergies, hypertension or heart disease) or if you are over 65 years of age. 

Some workers might be at greater risk than others if they have not built up a tolerance to hot conditions. Operations involving high air temperatures, radiant heat sources, high humidity, direct physical contact with hot objects or strenuous physical activities have a high potential for inducing heat stress in employees engaged in such operations. When working in high-heat environments, don’t depend on thirst or sweat as an indicator of escalating body heat. Thirst is not always a dependable gauge and sweat may evaporate quickly, especially in dry-heat environments. Instead, be aware of the temperature and humidity, and drink fluids with electrolytes at regular intervals. It is much easier to prevent heat stress injuries than to recover from them. 

Be aware of the environment in which you work. Such places include iron and steel foundries, non-ferrous foundries, brick-firing, ceramic plants, glass products facilities, rubber products facilities, electrical utilities (particularly boiler rooms), bakeries, confectioneries, commercial kitchens, laundries, food canneries, chemical plants, mining sites, smelters and steam tunnels. 

To prevent heat-related illnesses such as fainting, heat cramps and heat exhaustion, new workers should work shorter workdays in the heat during their first one to two weeks. Fainting may occur when an employee who is not used to the heat stands in one position for an extended period of time. An employee who has fainted should recover after a brief period of sitting or lying down. Moving around, rather than standing still, will reduce the possibility of fainting. Heat cramps are painful cramps that occur in the arms, legs or stomach while on the job, but they can occur later at home. Move to a cool area at once if cramping is experienced. Loosen clothing and drink cool, lightly salted water or a commercial hydration beverage. Seek medical aid if the cramps are severe or don’t go away. Heat exhaustion is caused by the loss of large amounts of fluid by sweating, sometimes with excessive loss of salt. An employee suffering from heat exhaustion still sweats but may experience the signs and symptoms mentioned previously. To treat heat exhaustion, move the victim to a cool place. Keep the victim lying down with legs straight and elevated eight to 12 inches. Cool the victim by applying cold packs, wet towels or clothes, and fan the victim while providing a cool drink to rehydrate. It is important to stay hydrated because fluid loss can negatively impact performance. The victim should partially recover within 30-60 minutes. If not, seek medical attention. The victim should be fully recovered within 24-48 hours.

Heat-related illness can be prevented by following the “Rule of 20 percent” to build heat tolerance. New workers should only work 20 percent of the normal duration on their first day in the heat. Increase work duration by 20 percent on subsequent days until the worker is performing a normal schedule. Workers may need additional time (up to 14 days for some) depending on their health. Heat illness can also be prevented by remembering these simple phrases: drink water often; rest in the shade; take breaks; limit heat. 

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