Heat Related Illness and First Aid

Heat stroke, the most serious form of heat-related illness, happens when the body becomes unable to regulate its core temperature. Sweating stops and the body can no longer rid itself of excess heat. Signs include confusion, loss of consciousness, and seizures. "Heat stroke is a medical emergency that may result in death! Call 911 immediately.

Heat exhaustion is the body's response to loss of water and salt from heavy sweating. Signs include headache, nausea, dizziness, weakness, irritability, thirst, and heavy sweating.

Heat cramps are caused by the loss of body salts and fluid during sweating. Low salt levels in muscles cause painful cramps. Tired muscles—those used for performing the work—are usually the ones most affected by cramps. Cramps may occur during or after working hours.

Heat rash, also known as prickly heat, is skin irritation caused by sweat that does not evaporate from the skin. Heat rash is the most common problem in hot work environments.

The chart below shows symptoms and first aid measures to take if a worker shows signs of a heat-related illness.

Illness	Symptoms	First Aid*
Heat stroke	Confusion Fainting Seizures Excessive sweating or red, hot, dry skin Very high body temperature	Call 911 While waiting for help: Place worker in shady, cool area Loosen clothing, remove outer clothing Fan air on worker; cold packs in armpits Wet worker with cool water; apply ice packs, cool compresses, or ice if available Provide fluids (preferably water) as soon as possible Stay with worker until help arrives
Heat exhaustion	Cool, moist skin Heavy sweating Headache Nausea or vomiting Dizziness Light headedness Weakness Thirst Irritability Fast heart beat	Have worker sit or lie down in a cool, shady area Give worker plenty of water or other cool beverages to drink Cool worker with cold compresses/ice packs Take to clinic or emergency room for medical evaluation or treatment if signs or symptoms worsen or do not improve within 60 minutes. Do not return to work that day
Heat cramps	Muscle spasms Pain Usually in abdomen, arms, or legs	Have worker rest in shady, cool area Worker should drink water or other cool beverages Wait a few hours before allowing worker to return to strenuous work Have worker seek medical attention if cramps don't go away
Heat rash	Clusters of red bumps on skin Often appears on neck, upper chest, folds of skin	Try to work in a cooler, less humid environment when possible Keep the affected area dry
* Remember, if you are not a medical professional, use this information as a guide only to help workers in need.

Fall Prevention: Plan, Provide, Train

FALLS ARE THE LEADING CAUSE OF DEATH IN CONSTRUCTION. In 2010, there were 264 fall fatalities (255 falls to lower level) out of 774 total fatalities in construction. These deaths are preventable.

Falls can be prevented and lives can be saved through three simple steps:

• Plan
• Provide
• Train

PLAN ahead to get the job done safely
When working from heights, such as ladders, scaffolds, and roofs, employers must plan projects to ensure that the job is done safely. Begin by deciding how the job will be done, what tasks will be involved, and what safety equipment may be needed to complete each task.

When estimating the cost of a job, employers should include safety equipment, and plan to have all the necessary equipment and tools available at the construction site. For example, in a roofing job, think about all of the different fall hazards, such as holes or skylights and leading edges, then plan and select fall protection suitable to that work, such as personal fall arrest systems (PFAS).

PROVIDE the right equipment
Workers who are six feet or more above lower levels are at risk for serious injury or death if they should fall. To protect these workers, employers must provide fall protection and the right equipment for the job, including the right kinds of ladders, scaffolds, and safety gear.

Different ladders and scaffolds are appropriate for different jobs. Always provide workers with the kind they need to get the job done safely. For roof work, there are many ways to prevent falls. If workers use personal fall arrest systems (PFAS), provide a harness for each worker who needs to tie off to the anchor. Make sure the PFAS fits, and regularly inspect all fall protection equipment to ensure it's still in good condition and safe to use.

TRAIN everyone to use the equipment safely
Falls can be prevented when workers understand proper set-up and safe use of equipment, so they need training on the specific equipment they will use to complete the job. Employers must train workers in hazard recognition and in the care and safe use ladders, scaffolds, fall protection systems, and other equipment they'll be using on the job.

Fall Prevention Tips from OSHA

Falls and falling objects can result from unstable working surfaces, ladders that are not safely positioned, and misuse of fall protection. Workers are also subject to falls or to the dangers of falling objects if sides and edges, floor holes, and wall openings are not protected. Any time a worker is at a height of six feet or more (construction industry) or four feet or more (general industry), the worker must be protected.

Fall Protection

Fall protection must be provided for each employee on a walking/working surface with an unprotected side or edge at the height required by the OSHA standard applicable to their work environment. Management is required to:

• Develop, implement and commit to a fall protection program
• Provide training on the fall protection program
• Evaluate the program on a regular basis to insure the program’s effectiveness and determine whether it needs to be changed or updated

Employers are required to assess the workplace to determine if the walking/working surfaces on which employees are to work have the strength and structural integrity to safely support workers.

Once employers have determined that the surface is safe for employees to work on, the employer must select one of the options listed for the work operation if a fall hazard is present.

• Where protection is required, select fall protection systems appropriate for given situations.
• Use proper construction and installation of safety systems.
• Supervise employees properly.
• Train workers in the proper selection, use, and maintenance of fall protection systems.

Unprotected Sides, Wall Openings, and Floor Holes

Almost all sites have unprotected sides and edges, wall openings, or floor holes at some point during construction. If these sides and openings are not protected at your site, injuries from falls or falling objects may result, ranging from sprains and concussions to death.

• Use at least one of the following whenever employees are exposed to a fall of 6 feet or more [see comment above] above a lower level:
  • Guardrail Systems
  • Safety Net Systems
  • Fall Arrest Systems
• Cover or guard floor holes as soon as they are created.
• Guard or cover any openings or holes immediately.
• Construct all floor hole covers so they will effectively support two times the weight of employees, equipment, and materials that may be imposed on the cover at any one time.
• In general, it is better to use fall prevention systems, such as guardrails, than fall protection systems, such as safety nets or fall arrest devices.

Ladders

You risk falling if portable ladders are not safely positioned each time they are used. While you are on a ladder, it may move and slip from its supports. You can also lose your balance while getting on or off an unsteady ladder. Falls from ladders can cause injuries ranging from sprains to death.

• Position portable ladders so the side rails extend at least three feet above the landing
• Secure side rails at the top to a rigid support and use a grab device when a three-foot extension is not possible.
• Make sure that the weight on the ladder will not cause it to slip off its support.
• Before each use, inspect ladders for cracked, broken, or defective parts.
• Do not apply more weight on the ladder than it is designed to support.
• Use only ladders that comply with OSHA standards.

OSHA announces stand-down to prevent falls in construction

On March 19, OSHA announced a national safety stand-down from June 2 to 6 to raise awareness among employers and workers about the hazards of falls, which account for the highest number of deaths in the construction industry.

“Falls account for more than a third of all deaths in this industry,” said Dr. David Michaels, assistant secretary of labor for occupational safety and health. “We’re working with employers, workers, industry groups, state OSH plans, and civic and faith-based organizations to host safety stand-downs that focus on recognizing hazards and preventing falls. We are getting the message out to America’s employers that safety pays and falls cost.”

During the stand-down, employers and workers are asked to pause their workday to talk about fall prevention in construction, and discuss topics like ladder safety, scaffolding safety and roofing work safety. OSHA has also launched a national safety stand-down website with information on how to conduct a successful stand-down. Afterwards, employers will be able to provide feedback and receive a personalized certificate of participation.

The stand-down is part of OSHA’s ongoing Fall Prevention Campaign, which was started in 2012 and was developed in partnership with the National Institute for Occupational Safety and Health (NIOSH) and NIOSH’s National Occupational Research Agenda program. The campaign provides employers with information and educational materials on how to plan ahead to prevent falls, provide the right equipment for their workers, and train all employees in the proper use of that equipment.

“We are pleased to join again with OSHA and our NORA partners to focus on fall prevention at construction sites,” said Dr. John Howard, NIOSH director. “Preventing falls in the construction industry benefits everyone, from the worker, to the employer, to the community at large. This safety stand-down serves as an important opportunity for everyone to take the time to learn how to recognize and prevent fall hazards.”

Fall protection in construction is consistently one of OSHA’s most frequently violated regulations. In fiscal year (FY) 2013, it was the most frequently cited standard, with 8,241 violations. Other top violations in FY 2013 also involved fall hazards, such as scaffolding in construction, with 5,423 violations, and ladders in construction, with 3,311 violations.