The catastrophic oil spill in the Gulf of Mexico this past April and the current massive cleanup work bring into sharp focus the hazards of heat stress.

During days this summer, the heat index along the Gulf shores regularly climbs well above 100 degrees, sometimes forcing workers to work for only 15 minutes at a time before taking longer breaks to avoid overheating. The work is grueling and physical. Reported heat-related symptoms have included dizziness, headache, nausea, muscle cramping and shortness of breath.

NIOSH notes in its publication “Occupational Exposure to Hot Environments,” (1986) that although workers can acclimatize themselves to different levels of heat, each worker has an upper limit for heat stress beyond which the worker can become a heat casualty.

How the body releases heat

• Sixty-five percent of the body’s heat is released through radiation. This occurs when ambient air temperature is lower than the body’s skin temperature. Radiation is the movement of heat energy from a warmer object to a cooler object as heat radiates from the sun to the earth.
• Convection accounts for approximately ten percent of heat loss. Convection is the transfer of heat energy from a warmer object or space to a cooler object or space through differences in density and the action of gravity.
• Approximately 23 percent of heat loss is due to evaporation of perspiration from the skin. Evaporation is the cooling of a surface through the process of a liquid changing to a vapor and leaving that surface.
• Conduction will add another two percent to the heat loss total. Conduction is the transfer of heat energy from a warmer object to a cooler object through direct contact.

When the ambient temperature of the surrounding air is 95°F or higher, radiation, convection, and conduction stop working. Evaporation is all that is left to cool the body. Protective clothing used by welders, firefighters, racers and hazmat workers will make the heat situation even worse.

Heat-induced errors

A performance study by NASA using telegraph key operators showed that in temperatures of 80°F, the operator will make five errors an hour and 19 mistakes after three hours. At 90°F the operators made nine mistakes per hour and 27 after three hours. At 95°F the mistakes went to 60 in one hour and 138 in three hours. Although errors made by telegraph key operators may not be critical, this same hot environment will produce a proportional amount of errors regardless of the task.

When a person is in a hot environment, up to 48 percent of the blood is pumped by the heart to the skin for cooling. The first effect is to release heat, but water is also released through perspiration. If an individual loses two percent of body weight due to perspiring, that person is considered to be in a heat exhausted state. A study by Wasterlund and Chaseling(1) placed forest workers in a controlled environment, where one group was properly hydrated and the other dehydrated to an extent of one percent of body weight loss. The test included the time taken to debark and stack 2.4 cubic meters of plywood. They found a 12-percent decrease in productivity from the dehydrated group.

Another study by Gopinthan et al(2) focused on mental performance and the effects of dehydration on the decision-making process and could be related to an increase in work-related accidents. The study concluded that with two percent of body weight loss, visual motor tracking, short-term memory, attention and arithmetic efficiency were all impaired. In the extreme, the study notes that a 23-percent reduction in reaction time occurred with a four percent body fluid loss.

When heat overtakes the body

At the ambient temperature of 95°F, the body no longer keeps up with its internal heat generation levels and inner core temperature begins to rise. The only mechanism to release body heat from the inner core is for up to 48 percent of the body’s blood to be pumped to the skin to create perspiration. This creates two problems: blood loss to the organs, muscles and brain; and dehydration. When the brain, muscles and major organs are receiving half of the blood they normally receive the heart must work much harder to try to deliver the same volume of blood to those organs to keep them nourished by beating up to 150 times a minute. Factor in a thickening of the blood due to fluid loss (dehydration) and you can understand why heart attacks are a major by-product of heat stress.

When an employee performs heavy physical work, fluid intake may not overcome the effects of sweat output. Employees who perform duties in fully encapsulated protective clothing may have increased sweat rates of 2.25 liters per hour. Other studies link job-related accidents to “Orthostatic intolerance.” Carter et al(3) established that with a three-percent dehydration state due to heat exposure, subjects experienced a significant reduction in cerebral blood flow velocity when changing from a seated to standing position that can cause workers to lose consciousness. It can take as much as 24 hours for the body to absorb enough fluid to fully rehydrate. Godek, Bartolozzi, et al(4) have shown that fluid intake alone does not reduce core body temperature.

Cooling workers

Work should be curtailed while fluid is replaced, or the dehydration rate must be slowed by using personal cooling methods such as misting fans, ice vests or active cooling products which pump cooled fluid through tubing or a bladder sewn to a garment that the employee wears under the protective clothing. If not, the inner core temperature will continue to rise for up to 30 minutes after work is stopped, unless other means are used to cool the blood that has been pumped to the skin for cooling. Pre-cooling, continuous cooling and post or rehab-cooling will increase productivity of workers. Rehab cooling has been proven to bring workers vital signs to normal quickly and safely, getting them back to work sooner.

The “OSHA Technical Manual” (Section III: Chapter 4) talks about how active cooling products using water are useful in preventing heat stress by using conduction to enhance the body’s capacity to cool. In fact, it has been demonstrated that water is 28 times faster in cooling a subject than cooled air. These products slow the rate at which the core body temperature rises by using conduction to greatly increase the body’s capacity to cool the blood that is pumped to the skin during times of elevated core temperatures. This slows the fluid loss caused by sweating. By using shirts and vests that incorporate active cooling on about 40 percent of the body surface, the danger of heat stress can be greatly reduced.

Training and company policies must help employees decide that they can protect themselves from heat stress. Reducing heat stress will improve productivity and reduce accidents at the workplace.

References

1. Wasterlund DS, Chaseling J, Burstrom L: The effect of fluid consumption on the forest workers’ performance strategy. Appl Ergon 35:29-36, 2004

2. Gopinathan PM, Pichan G, Sharma VM: Role of dehydration in heat stress-induced variations in mental performance. Arch Environ Health 43:15-17, 1988

3. Carter R 3rd, Cheuvront SN, Vernieuw CR, Sawka MN: Hypohydration and prior heat stress exacerbates decreases in cerebral blood flow velocity during standing. J Appl Physiol 101:1744-1750, 2006

4. Godek S, Bartolozzi A, Burkholder R, Sugarman E, Dorshimer G: Core temperature and percentage of dehydration in professional football linemen and backs during preseason practice. J Athl Train 41(1):8-17, 2006