Summer’s here, bringing with it the dangers of heat-related injuries such as dehydration, cramps and heat stroke. In addition, soaring temperatures and blinding sunlight are causing fatigue, eyestrain and a loss of concentration that all too often result in accidents, diminished job performance and reduced productivity.

As safety and health professionals, we are well aware of the consequences of each stage of heat-related injury. The key to safety is education that enables employees to make individualized assessments before medical attention becomes necessary. By following a few basic guidelines, we can ward off the direct consequences of exposure to heat and sun as well as the secondary challenges of heat-related fatigue and loss of concentration.

Gradually build up tolerance
Depending on the duration of heat exposure, a person should gradually build up tolerance, a process that can take up to two weeks. Since acclimation time and heat tolerance are highly dependent on the work environment and a person’s overall physical condition, it is necessary to evaluate each employee according to his or her unique health care needs. For instance, an older, overweight, out-of-shape individual from another geographical area will not acclimate at the same rate as a young, trim, fit individual from the immediate geographic area.

Clothing and PPE can make a significant difference in core body temperature and acclimation times. Light, loose fitting and breathable fabrics are preferred whenever practical. This is widely known and accepted, but often we fail to convey this message to all employees. Working with heavy, personal protective equipment (PPE) requires more frequent rest breaks and possibly longer acclimation time. Chemical-resistant body protection and fire-resistant clothing typically retain heat and also extend acclimation times.

Eliminate the risk of heat stress
The body allows extra heat to be removed by “pumping” moisture to the skin and removing it through evaporation. Muggy and humid days do not allow for as much evaporation, so overexertion on hot and humid days should be limited. To eliminate the risk of heat stress, encourage workers to:

• Take breaks in a cool, shady spot and use fans when possible.
• Replenish fluids, alternating drinking water and electrolytes; the ratio of water to electrolyte drinks should be 3 to 1 every 15 to 20 minutes (1 cup = 8 ounces). Limit drinks with caffeine. Check what time the coffee pot gets turned off and note the caffeine levels in the beverages in the vending machines. Make sure employees understand that popular “energy” drinks are often loaded with caffeine and increase the risk of heat-related injuries.
• Wear light-colored clothing made of cotton.
• Use the buddy system to perform tasks.
• Avoid eating large meals before working in a hot environment.

Avoid sunburn & other sun-related damage
Sunburns develop when the amount of UV exposure is greater than the protection the skin’s melanin can provide, causing premature aging due to damaged elastin fibers. Other signs of skin damage are brown spots or patches. Some medications and cosmetics can cause or increase an individual’s sensitivity to sunlight and should be avoided, if possible, by those working outside.

Sunlight contains 3 types of UV rays that can cause sunburn on the acute side, and cancer on the chronic side.

• UVA rays cause skin aging and wrinkles. Tanning beds and a person’s natural skin pigmentation can give a false sense of protection from the sun.
• UVB rays cause sunburns, cataracts, immune system damage, and skin cancer; in fact, melanoma may be associated with severe UVB sunburns occurring before the age of 20. Only a broad spectrum sunscreen will protect from UVB rays. The SPF rating should not be your only concern — always look for a broad spectrum protection that includes protection for both UVA and UVB.
• UVC rays are the most dangerous. These rays are typically blocked by the ozone layer.

It is impossible to completely avoid sunlight, especially if you work out-of-doors. Even on cloudy, cool or overcast days, UV rays travel through the clouds and reflect off sand, water, snow and even concrete. Clouds and pollution can give a false sense of protection but don’t be fooled; the “invisible sun” is still causing sunburn and skin damage.

Take precautions to limit exposure to damaging UV rays by avoiding, whenever possible, the strongest hours of sunlight — between 10 a.m. and 4 p.m. Also, determine the UV index in your area; it can usually be found in the newspaper, on TV and radio news broadcasts, or on the Web at www.epa.gov/sunwise/uvindex.html.

Guard against melanoma
According to Myles G. Cockburn of the University of Southern California, the rate of melanoma (the most deadly kind of skin cancer) is rising at twice the rate among Latino men as white men. (“The Developing Epidemic of Melanoma in the Hispanic Population of California.” Cancer. 2006;106;1162-8). Based on 14 years (1988-2001) of health care data that included all melanomas identified in California, the study concluded that there is a significant increase in thicker tumors (greater than 1.5 millimeters) in the Latino male population.

In order to guard against the risk of melanoma, employees should have their skin examined every year by a doctor and should perform self-examinations, being careful to look out for the “ABCDs”:

• A – asymmetry. Spots or marks should not be irregular.
• B – boarder. Spots or marks should have smooth edges.
• C – color. They should be uniform in color. Black moles should be examined by a doctor.
• D – diameter. The mole should be smaller than a pea (6 mm).

Since the sun can cause damage year round, use sun protection every day to prevent skin cancer. Using SPF 30+ instead of SPF 15+ does not mean you can safely double time in the sun. Apply sunscreen 20 minutes before going outside, and don’t forget to protect the lips and nose with lip balm and sunscreen.

Provide outdoor eye safety
Spending long hours in the sun with no eye protection may increase the chance of developing cataracts, but even low amounts of sunlight can increase the risk of eye disorders. UVB damage to the eyes is cumulative, so it is never too late to start protecting the eyes.

When selecting eye protection, simple sunglasses offer excellent protection, but make sure the lenses are designed to block out 95% of UV rays. Polarizing lenses and mirror finishes reduce glare but have little effect in blocking the absorption of UV rays.

Simple precautions prevent serious problems
Summertime calls for added awareness and education to ensure many years of health and well-being. Don’t forget to provide employees with ample supplies of sunscreen and appropriate eye protection, and be certain to encourage sufficient rest and fluid replenishment. Most importantly, arm them with information that will prevent sun-related injuries, whether at home or on the job.