Understanding Heat Illness and Injury – Part 1

steel worker on building

Heat-related illness and injuries are a growing concern for businesses that operate both indoors, outdoors, and a hybrid of both. Heat warnings and advisories often focus on people who work directly underneath the scorching sun while conducting manual labor when temperatures exceed 80 degrees (F).  Additionally, heat-related illnesses and injuries impact workers inside buildings and in confined spaces. Hot days outside can easily raise the temperature inside when the building is not properly ventilated, does not have air conditioning, and when large machines serve as an additional heat source. Furthermore, when employees move between cool and warm spaces, they may not be aware of the toll a dramatic rise in temperature may have on their bodies.

Knowing the signs of heat illness and the situations that put people at risk are key steps in providing a safe workplace and preventing adverse medical events.

Heat illness can range from minor to moderate to an emergency. Minor symptoms are temporary dehydration, heat cramps in the legs or abdomen, or sunburn on exposed skin. Minor symptoms quickly resolve by drinking water, resting, or moving into the shade or a cooler place. 

Moderate symptoms of heat illness, also known as heat exhaustion, are more concerning because the body does not have enough water to work as it should. This may be due to consuming an insufficient amount of water or losing too much fluid through sweating. The insufficient amount of water in the body leads to an imbalance of electrolytes. Electrolytes are essential minerals— such as sodium, potassium, and calcium— that help the organs in the body function properly. A person suffering from heat exhaustion may look unlike their normal self.

Symptoms of Heat Illness

  •   Muscle cramping lasting longer than one hour
  •   Fatigue
  •   Headache
  •   Nausea or vomiting
  •   Dizziness or fainting

If this occurs—act quickly! Ensure the person has water to drink and can rest in a cool place until symptoms resolve. If you have an on-site medical team, reach out to them so they can provide immediate care and determine if the person is experiencing a more serious condition called heat stroke.

Heatstroke is a 911 medical emergency and an OSHA-reportable adverse event. While you wait for 911, keep the employee cool by placing cool cloths over their body and offer water if they can safely consume it. 

Heatstroke Symptoms

  •     A body temperature greater than 103°F (39.4°C)
  •     Red, hot, and dry skin (no sweating)
  •     Rapid, strong pulse
  •     Throbbing headache
  •     Dizziness
  •     Nausea
  •     Confusion
  •     Unconsciousness

An unwell employee experiencing heat-related illness may also experience a heat-related injury. When someone is experiencing heat illness, they may not be able to fully concentrate on their work or perform tasks safely. Sweaty hands, fogged-up glasses, decreased concentration, and hot-to-the-touch machines and tools are factors of heat-related injuries.

Many employees may not be aware of situations in which they are at increased risk for heat illness and injury. One scenario involves a person who primarily works in well-ventilated spaces but performs tasks in confined spaces for long stretches of time. This may describe the typical work performed by maintenance and facilities workers. Confined spaces often trap air and become much hotter than the area enclosing it. Many companies also have employees who drive vehicles throughout the day. They may be responsible for delivering items or performing work on off-site locations. Spending time in a hot vehicle, without water, for a long time can make someone susceptible to heat illness and injury.  

Knowing the signs and symptoms of heat illness can help you respond immediately and effectively to prevent a serious adverse event from occurring. Furthermore, proactively identifying typical and atypical situations where extreme heat events occur can provide a layer of proactive injury prevention to help protect people in your business from experiencing heat-related illness and injury. See part two here.

Work Health Solutions

Work Health Solutions

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Work Health Solutions is dedicated to preserving a safe work environment and improving existing programs and care for local, regional and national organizations.

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Dr. Glen Cheng

A physician-attorney with a dedication to healthcare innovation, informatics, and digital health.

  • Currently spearheads employee health protection and promotion within the VA Pittsburgh Health Care System.
  • Trained in residency at Harvard, achieving board certification as a physician; also a licensed patent attorney with experience as FDA regulatory counsel.
  • Co-founded Acceleromics, a consulting firm providing clinical and regulatory guidance to digital health startups.

Erin Davis

 Chief Clinical Officer at Work Health Solutions, certified in Adult-Gerontology (AGNP-C) and Athletic Training (ATC).

  • Oversees clinical operations and ensures high clinical standards across the company’s national field staff.
  • Former Manager of Clinic Operations and Occupational Health Nurse Practitioner at Stanford University Occupational Health Center (SUOHC).
  • Specialized in treating occupational injuries and illnesses, and provided medical surveillance and travel medicine consults at Stanford and SLAC National Accelerator Lab.
  • Dedicated to sports and occupational injury treatment and prevention.
  • Assistant Clinical Faculty at UCSF, mentoring students in clinical rotations within the Adult Gerontology and Occupational and Environmental Health Program.
  • Holds leadership roles as Treasurer and President Elect of the California El Camino Real Association of Occupational Health Nurses (CECRAOHN), affiliated with the American Association of Occupational Health Nurses (AAOHN).

Dr. Robert Goldsmith

Founder and President of NBS Healthcare Group, with a focus on innovation in healthcare consulting.

  • Previous role as Executive Director for Employee Health at Novartis Services, Inc., leading health services and clinical support.
  • Instrumental in creating an integrated healthcare system at Novartis.
  • Former private practice in internal medicine in Stamford, Connecticut, and Medical Director consultant for GTE Corporation.
  • Transitioned to GE as a Global Medical Director in 2000.
  • Holds a medical degree from Albert Einstein College, an MPH from the University of Connecticut, and completed training at Greenwich Hospital and Yale-New Haven Medical Center.
  • Assistant professor in the Department of Medicine at the Vagelos School of Medicine, Columbia University.
  • Serves as a team physician for high school athletes in Stamford.
  • Published works on occupational health risks, primary prevention, and exercise-induced asthma.