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Understanding and Preventing Heat-Induced Illnesses

Wed July 17, 2002 - Northeast Edition
Construction Equipment Guide

During the hazy, crazy days of the summer months, heat stress-related illnesses are the number one cause of sick days taken by employees, and also are one of the causal factors of loss time accidents and fatalities at the workplace. Each summer, excessive heat causes almost 3,000 deaths in the United States alone.

Heat stress occurs when the combination of the environment, workload, personal protective equipment and clothing produces enough stress on the body to interfere with the body’s own natural cooling mechanisms, which may result in adverse physiological effects. Heat stress-related disorders and illnesses include heat rash, heat cramps, heat syncope, dehydration, heat exhaustion and heat stroke.

• Heat rashes are skin eruptions caused by prolonged and uninterrupted sweating and/or lack of personal hygiene. One can prevent and treat heat rashes by keeping the affected area as clean as possible and by using talcum powder or body lotions.

• Heat cramps are caused by an electrolyte imbalance caused by prolonged sweating and inadequate fluid and electrolyte replacement. The victim will usually have cramping in the abdominal and skeletal muscles. One can prevent and treat heat cramps by the adequate intake of both fluids and electrolytes.

• Heat syncope is the confusion or disorientation a worker may experience after standing prone in a hot environment for an extended period of time. It is caused by the blood pooling in feet and ankles. One can prevent and treat syncope by the periodic moving of the legs and with the intake of water.

• Dehydration is caused by the excessive fluid loss caused by sweating, illness, diarrhea, or the consumption of alcohol. The victim may have fatigue, weakness, dizziness or a dry mouth. One can prevent and treat dehydration with the intake of both water and electrolytes.

• Heat exhaustion is caused by dehydration and the pooling of blood in the extremities. The victim may experience fatigue, weakness, blurred vision, profuse sweating, headache and nausea. Prevent heat exhaustion by the adequate intake of fluids and electrolytes and periodic resting.

What Happens to the Body

Headaches; dizziness; light-headedness; weakness; mood changes (irritable; or confused/can’t think straight); feeling sick to your stomach, vomiting/

throwing up; decreased and dark colored urine; fainting; passing out; and pale, clammy skin.

What Should Be Done

• Move the person to a cool shaded area to rest. Don’t leave the person alone. If the person is dizzy or light headed, lay them on their back and raise their legs about 6-8 inches. If the person is sick to their stomach lay them on their side.

• Loosen and remove any heaving clothing.

• Have the person drink a small cup of cool water every 15 minutes if they are not feeling sick to their stomach.

• Try to cool the person by fanning them. Cool the skin with a cool spray mist of water or wet cloth.

• If the person does not feel better in a few minutes call for emergency help.

If heat exhaustion is not treated, the illness may advance to heat stroke.

• Heat stroke is the most dangerous of heat stress-related illnesses. The body of the victim can no longer cool itself and the core body temperature has risen to critical levels. The victim will seem confused if still conscious, and will have warm, dry skin, since the body can no longer produce sweat to cool itself.

What Happens to the Body

Dry, pale skin — no sweating; hot red skin — looks like a sunburn; mood changes — irritable, confused, not making any sense; seizures, fits; and collapse; passed out — will not respond.

What Should Be Done

• Call for emergency help.

• Move the person to a cool shaded area. Don’t leave the person alone. Lay them on their back and if the person is having seizures/fits, remove any objects close to them so they won’t strike against them. If the person is sick to their stomach lay them on their side.

• Remove any heavy and outer clothing;

• Have the person drink a small cup of cool water every 15 minutes if they are alert enough to drink anything and not feeling sick to their stomach.

• Try to cool the person by fanning them. Cool the skin with a cool spray mist of water, wet cloth, or wet sheet.

• If ice is available, place ice packs under the arm pits and groin area.

Protecting Yourself Against Harmful Sunlight

The number of new cases of skin cancer, and the number of deaths caused by the most serious type of skin cancer are rapidly rising in the United States. This is particularly troubling since the numbers for most cancers have been declining. Sunlight is the main source of ultraviolet radiation (UV) known to damage the skin and to cause skin cancer. The amount of UV exposure depends on the strength of the light, the length of exposure, and whether the skin is protected. There are no safe UV rays or safe suntans.

Sun exposure at any age can cause skin cancer. Skin and eyes are most susceptible to sun damage. People need to be especially careful in the sun if they have numerous moles, irregular moles, or large moles; freckles or burn before tanning; fair skin, or blond, red, or light brown hair; or spend a lot of time outdoors.

Melanoma is the most serious type of skin cancer, and accounts for more than 75 percent of the deaths due to skin cancer. In addition to skin cancer, sun exposure can cause premature aging of the skin, wrinkles, cataracts, and other eye problems.

If you work outdoors, there are five important steps you can take to protect against UV radiation and skin cancer:

1. Cover up. Wear clothing to protect as much of your skin as possible. Wear clothing that does not transmit visible light. To determine if the clothing will protect you, try this test: Place your hand between the fabric and a light source. if you can see your hand through the fabric, the garment offers little protection against sun exposure.

2. Use a sunscreen with an SPF of 15 or higher. Experts recommend products with a Sun Protection Factor, or SPF, of at least 15. The number of the SPF represents the level of sunburn protection provided by the sunscreen. An SPF 15 blocks out 93 percent of the burning UV rays; an SPF 30 blocks out 97 percent of the burning UV rays. Products labeled “broad spectrum” block both UVB and UVA radiation. Both UVA and UVB contribute to skin cancer.

3. Wear a hat. A wide brim hat is ideal because it protects the neck, ears, eyes, forehead, nose, and scalp. A baseball cap provides some protection for the front and top of the head, but not for the back of the neck or the ears, where skin cancers commonly develop.

4. Wear sunglasses that block UV rays. UV-absorbent sunglasses can help protect your eyes from sun damage. Ideal sunglasses do not have to be expensive, but they should block 99 to 100 percent of UVA and UVB radiation. Check the label to make sure they do. Darker glasses are not necessarily the best. UV protection comes from an invisible chemical applied to the lenses, not from the color or darkness of the lenses.

5. Limit direct sun exposure. UV rays are most intense when the sun is high in the sky, between 10 AM and 4 PM. If you are unsure about the sun’s intensity, take the shadow test: If your shadow is shorter than you, the sun’s rays are the strongest. Seek shade whenever possible.

You may also want to check the UV Index for your area. The UV index usually can be found in the local newspaper or on TV and radio news broadcasts. It gives the expected noon-time UV radiation reaching the earth’s surface on a scale of 1 to 10 plus. It is forecast daily for 58 cities. The higher the number, the greater the exposure to UV radiation. The index helps determine when to avoid sun exposure and when to take extra protective measures.

Skin cancers detected early can almost always be cured. The most important warning sign for skin cancer is a spot on the skin that is changing in size, shape, or color over a period of 1 month to 1-2 years. The most common skin cancers — basal cell and squamous cell — often take the form of a pale, wax-like, pearly nodule; a red scaly, sharply outlined patch; or a sore that does not heal; whereas melanoma often starts as a small, mole-like growth.

How to Protect Workers from Heat

Stress-Related Illnesses

• Learn the signs and symptoms of heat-induced illnesses and what to do to help the worker.

• Train the workforce about heat-induced illnesses.

• Perform the heaviest work in the coolest part of the day.

• Slowly build up tolerance to the heat and the work activity (usually takes up to 2 weeks).

• Use the buddy system (work in pairs).

• Drink plenty of cool water (one small cup every 15-20 minutes).

• Wear light, loose-fitting, breathable (like cotton) clothing.

• Take frequent short breaks in cool shaded areas (allow your body to cool down).

• Avoid eating large meals before working in hot environments.

• Avoid caffeine and alcoholic beverages (these beverages make the body lose water and increase the risk for heat illnesses).

Workers are at increased risk when:

• They take certain medication (check with a doctor, nurse, or pharmacy and ask if any medicines you are taking affect you when working in hot environments).

• They have had a heat-induced illness in the past.

• They wear personal protective equipment (like respirators or suits).

Learning More About Preventing

Skin Cancer?

There are many web sites with good information about preventing, detecting, and treating skin cancer, including the following:

American Cancer Society for melanoma and nonmelanoma skin cancers at, or call 800/ACS-2345.

Centers for Disease Control and Prevention, for various health materials including skin cancer at, or call 888/842-6355.

For more information on OSHA, visit the agency’s web site at http://www., call 800/321-OSHA or your nearest OSHA office. Teletypewrite; (TTY) number is 877/889-5267.

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