1.0 PURPOSE
The purpose of this procedure is to establish guidelines and requirements sufficient to ensure the health and safety of Nitro Construction Services employees during work in hot and cold environments.
2.0 RESPONSIBILITY
It is the responsibility of all Nitro Construction Services employees to be aware of their physical conditions and tolerance for extreme temperatures and comply with all necessary heat/cold stress precautions. The site Supervisor or Safety Officer will periodically spend sufficient time in the hot environment to observe the worker’s physical reactions to the temperature levels.
3.0 REFERENCES
Medical Merck Manual
OSHA Technical Manual, Section III, Chapter 4, Heat Stress
OSHA 3154 – 2010, Heat Stress Card
OSHA 3156 – 1998, The Cold Stress Equation
Center for Disease Control and Prevention – Cold Stress
4.0 DEFINITIONS
4.1 Cold Stress Advisory – Wind chill temperature or actual temperature of <25°F or lower.
4.2 Frostbite – An injury to the body that is caused by freezing. Frostbite causes a loss of feeling and color in the affected areas. Symptoms include reduced blood flow to hands and feet, numbness, tingling or stinging, aching, bluish, or pale waxy skin.
4.3 Heat Exhaustion – The signs and symptoms of heat exhaustion are headache, nausea, vertigo, weakness, thirst, and giddiness.
4.4 Heat Stress Advisory – Temperature exceeds 90°F with relative humidity above 40% or when the temperature is over 100°F.
4.5 HeatStroke – HEAT STROKE occurs when the body’s system of temperature regulation fails, and body temperature rises to critical levels. Heat stroke is a medical emergency. The primary signs and symptoms of heatstroke are confusion; irrational behavior; loss of consciousness; convulsions; a lack of sweating (usually); hot, dry skin; and abnormally high body temperature, e.g., a rectal temperature of 41°C (105.8°F). If body temperature is too high, it causes death.
4.6 Hypothermia – Abnormally low body temperature. Hypothermia occurs when the body has used up its stored energy. The body temperature is low enough to affect the brain. Early symptoms include shivering, fatigue, and loss of coordination, confusion, and disorientation. Late symptoms include no shivering, blue skin, dilated pupils, slowed pulse, and breathing and loss of consciousness.
5.0 PROCEDURE
5.1 Protecting Yourself from Heat Stress – Heat stress, from exertion or hot environments, places workers at risk for illnesses such as heat stroke, heat exhaustion, or heat cramps.
5.1.1 Heat Stroke – A condition that occurs when the body becomes unable to control its temperature and can cause death or permanent disability.
Symptoms:
• High body temperature
• Confusion
• Loss of coordination
• Hot, dry skin or profuse sweating
• Throbbing headache
• Seizures, coma
First Aid:
• Request immediate medical assistance.
• Move the worker to a cool, shaded area.
• Remove excess clothing and apply cool water to their body.
5.1.2 Heat Exhaustion – The body’s response to an excessive loss of water and salt, usually through sweating.
Symptoms:
• Rapid heartbeat
• Heavy sweating
• Extreme weakness or fatigue
• Dizziness
• Nausea, vomiting
• Irritability
• Fast, shallow breathing
• Slightly elevated body temperature
First Aid:
• Rest in a cool area.
• Drink plenty of water or other cool beverages.
• Take a cool shower, bath, or sponge bath.
• Get medical assistance if the condition worsens.
5.1.3 Heat Cramps – Affect workers who sweat a lot during strenuous activity. Sweating depletes the body’s salt and moisture levels.
Symptoms:
• Muscle cramps, pain or spasms in the abdomen, arms or legs
First Aid:
• Stop all activity and sit in a cool place.
• Drink clear juice or sports beverage or drink water with food. Avoid table salts.
• Do not return to strenuous work for a few hours after the cramps subside.
• Seek medical attention if you have the following: heart problems, are on a low-sodium diet, or if the cramps do not subside within one hour.
5.2 General Heat Stress Precautions
5.2.1 Drink small amounts of cool water frequently. The use of electrolyte-replenishing drinks, such as Gatorade/Sqwincher or diluted orange juice, is also beneficial. Non-carbonated beverages, caffeine, and alcoholic drinks should be avoided.
5.2.1.1 Employees shall have access to potable drinking water. Where it is not plumbed or otherwise continuously supplied, it shall be provided in sufficient quantity throughout the work shift.
5.2.2 Lightly salted foods during the summer season as a precaution, particularly during hot spells, unless otherwise medically advised.
5.2.3 Do not take salt tablets unless under the direction of a physician. Increased salty foods or tablets can lead to stomach and gastric irritation and may lead to edema.
5.2.4 Use of protective equipment such as respirators and impervious clothing reduces heat tolerance. Adjustments may be necessary for work activities.
5.2.5 Physical factors must be taken into consideration before beginning work. Physically fit employees who are acclimatized have higher heat tolerance than unacclimatized, unfit workers. Type of work, level of physical activity and duration, clothing color, weight, and breathability of the clothing must all be taken into consideration before beginning work.
5.2.6 Find a place to cool off periodically: a cool room, a shaded area, or a place with a breeze.
5.2.7 Employees shall have access to shade during the workday.
5.2.8 Use the buddy system. Each employee should observe coworkers for signs of heat stress, and initiate action to address heat stress issues.
5.2.9 Employees should advise their supervisor of any possible condition that might increase their susceptibility to heat stress disorders. These factors include but are not limited to:
• Health conditions, such as cardiovascular disease, diabetes or hypertension
• Poor physical condition
• Acute or chronic infection
• Diarrhea
• Skin trauma, such as sunburn or heat rash
• Recent alcohol consumption
• Obesity
• Advanced age
• Fatigue or lack of sleep
• Record of prior heat stroke
• Recent or chronic use of any drugs, especially diuretics
• Consumption of beverages containing caffeine
5.4 Precautions against Ultraviolet Radiation from Sunlight
5.4.1 Sunblock creams should be used.
5.4.2 Use of protective eyewear with UV filtration is encouraged.
5.5 Protecting Yourself from Cold Stress – Workers who are exposed to extreme cold or work in cold environments may be at risk of cold stress. Extremely cold or wet weather is a dangerous situation that can cause occupational illness and injuries such as hypothermia, frostbite, trench foot, or chilblains.
5.5.1 Hypothermia – A condition in which the body uses up its stored energy and can no longer produce heat. Often occurs after prolonged exposure to cold temperature.
Early symptoms:
• Shivering
• Fatigue
• Loss of coordination
• Confusion and disorientation Late symptoms:
• No shivering
• Blue skin
• Dilated pupil
• Slowed pulse and breathing
• Loss of consciousness
First Aid:
• Request immediate medical assistance.
• Move the victim into a warm room or shelter.
• Remove wet clothing.
• Warm the center of their body first – chest, neck, head, and groin – using an electric blanket; or use skin-to-skin contact under loose, dry layers of blankets, clothing, or towels.
• If conscious, warm beverages may help increase the body temperature. Do not give alcohol.
• Once the temperature has increased keep them dry and wrapped in a warm blanket, including the head and neck.
• If no pulse, begin CPR.
5.5.2 Frostbite – An injury to the body that is caused by freezing, which most often affects the nose, ears, cheeks, chin, fingers, or toes.
Symptoms:
• Reduced blood flow to hands and feet
• Numbness
• Aching
• Tingling or stinging
• Bluish or pale, waxy skin
First Aid:
• Get into a warm room as soon as possible.
• Unless necessary, do not walk on frostbitten feet or toes.
• Immerse the affected area in warm (not hot) water or warm the affected area using body heat. Do not use a heating pad, fireplace, or radiator for warming.
• Do not massage the frostbitten area; doing so may cause more damage.
5.5.3 Trench Foot – An injury of the feet resulting from prolonged exposure to wet and cold conditions that can occur at temperatures as high as 60ºF if the feet are constantly wet.
Symptoms:
• Redding of the skin
• Numbness
• Leg cramps
• Swelling
• Tingling pain
• Blisters or ulcers
• Bleeding under the skin
• Gangrene (foot may turn dark purple, gray or blue)
First Aid:
• Remove shoes/boots and wet socks.
• Dry feet.
• Avoid walking on feet, as this may cause tissue damage.
5.6 General Cold Stress Precautions
Recognize that cold-related injuries can result from the effects of low temperature plus wind speed plus wetness. The general precautions address those three issues.
5.6.1 Wear adequate insulated dry clothing.
5.6.2 Stay dry.
5.6.3 Layer loose clothing to facilitate adjustment for changing temperatures
5.6.4 If the air temperature falls below 39°F, gloves should be worn and cold protective clothing appropriate for the level of cold and physical activity must be worn.
5.6.5 Avoid direct contact of bare skin to any surface below 20°F to prevent contact frostbite.
5.6.6 If work is performed continuously at temperatures or wind chill temperatures below 20°F, warm break rooms should be used regularly.
5.6.7 Use the buddy system. Each employee should observe coworkers for signs of cold stress, and initiate action to address cold stress issues.
5.6.8 Drink warm beverages but avoid drinks with caffeine.
5.6.9 Employees should advise their supervisor of any possible condition that might increase their susceptibility to cold stress disorders. These factors are listed in Section 5.1.8.
5.7 Training
5.7.1 Supervisors shall receive training in this procedure to help prevent heat/cold-related illnesses before supervising employees working in heat/cold conditions. The supervisor should be knowledgeable of the symptoms of heat/cold-related illnesses and the emergency response procedure to follow when an employee exhibits symptoms consistent with possible heat/cold illnesses.
6.0 Appendices
6.1 NCS Form 030 – Wind Chill Chart
6.2 NCS Form 031– Heat Index Guide