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Thermo Stress. Lawrence S. Wong, CIH University of California Office of the President. Cold Stress. Cold Environment. Body’s Energy Used to Keep Internal Temperature Warm Shift Blood Flow From Extremities/Outer Skin to Body Core (Chest & Abdomen)
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Thermo Stress Lawrence S. Wong, CIH University of California Office of the President
Cold Environment • Body’s Energy Used to Keep Internal Temperature Warm • Shift Blood Flow From Extremities/Outer Skin to Body Core (Chest & Abdomen) • Results in Rapid Cooling of Extremities and Exposed Skin • Increases Chance for: • Hypothermia • Frostbite • Trench Foot
Wind Speed • 16 k/hr (10 mph) • Light Flag Fully Extended • 24 k/hr (15 mph) • Raises Newspaper Sheet Off the Ground • 32 k/hr (20 mph) • Wind Capable of Blowing Snow
Hypothermia - Means “Low Heat” • Body Heat Lost Faster than Replaced • Onset – Body Core Temperature Drops – 95OF • Symptoms – Pale & Cold Skin • Shiver, Stomp Feet, Lose Coordination, Slurred Speech, Fumble Items with Hands • Body Temperature Continues to Fall • Symptoms Worsen, Shivering Stops, Unable to Walk or Stand • Body Temperature of 85OF - Unconscious • Body Temperature of 78OF – Death Could Occur
Hypothermia Treatment • Mild Hypothermia • Move to Warm Area & Stay Active • Remove Wet Clothes & Replace with Dry Clothes or Blanket & Cover the Head • Drink Warm (Not Hot) Sugary Drink • Avoid Drinks with Caffeine • More Severe Hypothermia – Do All Above and: • Contact EMS • Cover All Extremities Completely & Place Warm Objects on Head, Neck, Chest & Groin • Arms & Legs Are Warmed Last
Severe Hypothermia Treatment • Treat Victim Very Gently • Do Not Apply External Heat to Re-Warm • Hospital Treatment is Required
Frostbite • Typically Affects Extremities – Feet & Hands • Skin Freezes and Loses Water • Usually Occurs at Temperatures < 30OF • Affected Body Part – Cold, Tingling, Stringing or Aching, Followed by Numbness • Skin • Color – Red, Then Purple, Then White • Cold to the Touch • Severe Cases - Blisters
Frostbite Treatment • Do Not Rub Affected Area to Warm It • Wrap Area in Soft Cloth • Move to Warm Area & Contact Medical Personnel • Do Not Pour Water on Affected Part • If Affected Part May Get Cold Again Do Not Warm • Warming & Re-Cooling – Cause Severe Tissue Damage
Trench Foot • Feet Immersed in Cold Water at Temperatures Above Freezing for Long Periods of Time • Similar to Frostbite, But Not as Severe • Symptoms – Tingling, Itching, or Burning Sensation. Blisters May Be Present • Soak Feet in Warm Water & Then Wrap with Dry Cloth Bandages • Drink Warm Sugary Drinks
Cold Stress Prevention • Plan for Work in Cold Weather • Wear Appropriate Clothing – 3 Layers • Outer Layer: Gortex® or Nylon – Break the Wind & Allow Some Ventilation • Middle Layer: Down or Wool – Absorb Sweat & Provide Insulation Even When Wet • Inner Layer: Cotton or Synthetic Weave – To Allow Ventilation • Layering Creates Air Pockets – Helps Retain Body Heat
Cold Stress Prevention • Wear Hat – Exposed Head: • Up to 40% Loss of Body Heat • Insulated Boots or Footwear • Wear One Thick or Two Thin Pairs of Socks • Too Many Socks Tighten Fit & Restrict Blood Flow • Hands Loose Dexterity < 59OF • Change of Dry Clothing–If Clothes Gets Wet • Do Not Wear Tight Clothing – Loose Air Pocket Insulation
Cold Stress Prevention • Avoid Alcohol and Caffeine • Increases Heat Loss Through Vasodilation • Take Breaks Out of the Cold • Schedule Work During Warmer Parts of Day • Older Workers or Certain Medical Conditions • May Be More Susceptible • Radiant Heater • Shielding Work Areas from Drafts & Wind to Reduce Wind Chill
Cold Stress Training • Proper Clothing & Equipment • Safe Work Practices • Guidelines for Eating & Drinking • Risk Factors That Increase Health Effects of Cold Exposure • How to Recognize Signs & Symptoms of Hypothermia, Frostbite, & Trench Foot • Appropriate First Aid Treatment, Including Warming Procedures
Heat Stress • Body Produces/Stores More Heat Than You Lose • Metabolism/Exercise • Heat Absorbed • Radiant Energy (Sun, Fire) • Conductive (Direct Contact) • Primary Heat Loss – Evaporation • Sweat/Evaporation • Function of Humidity & Temperature
Heat Illnesses • Heat Rash • Clogged/Irritated Sweat Glands • Heat Cramps • Painful Muscle Spasms–Electrolyte Imbalance • Heat Exhaustion • Heavy Sweating/Pale Clammy Skin • Normal Heart Rate/Body Temperature • Exert ional Heat Illness • Stuporous Appearance, Nausea, High Temperature, Headache
Heat Stroke High Body Temperature Hot, Red (Gray) Dry Skin, Rapid Pulse Confusion, Loss of Consciousness Death is Imminent Heat Stroke First Aid Loosen Tight Clothing Cool with Wet Cloth If Conscious, Slowly Give 4 oz of Water Every 15 Minutes Get Victim to Emergency Room ASAP Heat Illnesses
Heat Illness Prevention • Drink Fluids • Water – 4 Cups (1 Quart/Hour) • No Alcohol or Caffeine - Diuretics • Eat • Replace Electrolytes Lost by Perspiration
Heat Illness Prevention • Acclimation • Slow Process for Body to Condition Itself to Heat • May Take Up to 10 Days • Quickly Lost in a Matter of Days • Conditioning/General Health • Stay in Shape, Exercise Regularly • Watch Your Weight
Cal/OSHA Heat Illness Regulation Title 8 Cal. Code Regs., §3395 • Several Fatalities Due to Heat Stroke in California • Construction • Agriculture • Became Permanent in April 22, 2006 • Essentially Identical to Emergency Regulation
Heat Illness Prevention Standard: Application • All Outdoor Places of Employment • At Time When Environmental Factors for Heat Illness are Present • Air Temperature • Relative Humidity • Radiant Heat, Conductive Heat • Workload Severity/Duration • Personal Protective Clothing/Equipment
Outdoor Environments • Agriculture • Construction • Equipment and Storage Yard • Loading Docks • Tents • Structures with One or More Open Sides • Lack of Insulation/Heating From Sun • Limited Air Circulation
Potable Drinking Water • Sufficient Quantity at Beginning of Work Shift • Can Begin Shift with Smaller Quantities if Effective Replenishment Procedures Developed and Implemented • >1 Quart/Employee/Hour for Entire Shift • >2 Gallons/Employee/8-Hour Shift • Encourage Frequent Drinking of Water • Thirst – Unreliable Indicator of Dehydration
Access to Shade • Available for Employee(s): • Suffering from Heat Illness; or • Believe a Preventive Recovery Period is Needed • At Least 5 Minutes • Cool Down (Metabolic Heat/Heart Rate) • Rehydrate • Shade is: • Open to Air; or • Provided with Ventilation or Cooling for a Period of No Less Than 5 Minutes • Access to Shade Permitted at All Times
Heat Illness Prevention Training • Employee Training • Supervisor Training • Training Completed Prior to Assignment in Outdoor Environment with a Potential for Heat Illness
Risk Factors for Heat Illness Environmental Personal Employer’s Preventive Procedures Importance of Water Consumption Importance of Acclimation Types/Signs & Symptoms of Heat Illnesses Immediate Reporting Signs/Symptoms to Supervisor Employer’s Procedures Responding to Signs & Symptoms Emergency Medical Procedures Employee Training
Supervisor Training • Same Information in Employee Training • Procedures for Supervisor to Implement Heat Illness Prevention Program to Meeting Cal/OSHA Standard • Procedures Supervisor to Follow: • When Employee Exhibits Symptoms of Possible Heat Illness; and • For Emergency Response