2. How Hot Are You?

3. Heat Illness Prevention Daphne Thaung, MS, CIH Sarah Meyer, ASP UCSD Environment, Health & Safety http://blink.ucsd.edu/go/preventheatillness

5. Heat kills... your business! 16 jobsites were shut down in 2009 for imminent hazards due to heat16 jobsites were shut down in 2009 for imminent hazards due to heat Nearly $ 2 million in penalties and 1158 citations issued in 2009Nearly $ 2 million in penalties and 1158 citations issued in 2009 District Attorneys may review these cases for criminal activityDistrict Attorneys may review these cases for criminal activity Bad press/media attentionBad press/media attention 41 confirmed heat illnesses and 1 confirmed heat fatality in 200941 confirmed heat illnesses and 1 confirmed heat fatality in 2009 2009 Working Conditions

6. Personal Risk Factors May put employees at a higher risk of developing heat illness: –Age –Weight –Physical fitness/metabolism –Personal choices Prescription Drugs Alcohol/Caffeine/Water Consumption Food –Underlying Medical Conditions

7. Getting Acclimated 4 to 14 days working at least 2 hours/day Highest risk for heat illness: –At the start of the summer session –New employee –Coming back from illness or vacation Gradually getting used to the heat

8. Heat Illness Prevention During Heat Waves Take Extra Measures - More Water  Drink water more frequently before, during and after work  Water must be “readily accessible,” but in no case further than ¼ mile or a five- minute walk, and must be “fresh, pure, suitably cool”  Effective replenishment of extra supplies of water  Spraying body with water/wiping with wet towels

9. Supervisors/employees watch each other very closely & provide more frequent feedback Avoid working alone - “buddy system” Account for employee whereabouts throughout the work shift and end of the day Heat Illness Prevention During Heat Waves

10. Heat Illness Prevention During Heat Waves SHADE: blockage of direct sunlight –Take 5 minute breaks though out the day in shade –Eat lunch or rest in shade for longer breaks as well –Ex: buildings, canopies, umbrellas, trees

11. Is this adequate shade? The nearest shaded area must be as close as practicable. Usually this will mean that shade must be reachable within a 2 1/2 minute walk, but in no case more than 1/4-mile or a five minute walk away, whichever is shorter.

12. Examples of Acceptable Source of Shade –Take 5 minute breaks though out the day in shade –Eat lunch or rest in shade for longer breaks as well –Ex: buildings, canopies, umbrellas, trees If the temperature exceeds 90 F, shade must actually be present regardless of the previous day's predicted temperature high.

14. Heat Cramps Painful spasms of muscles Muscles used to perform the work are usually the ones most susceptible to cramps Cause: –Sweating heavily –Replacing water not salt Symptoms –Hot, moist skin –Normal pulse –Normal to slightly high body temperature

15. Heat Cramps Prevention Move into shade Loosen clothing Drink lightly salted liquids Wait to see if symptoms go away Seek medical aid if cramps persist

16. Heat Exhaustion Loss of fluid from sweating when worker has failed to drink enough fluids Cause: –Body’s heat-control mechanism is overactive –Loss of body fluids and minerals Symptoms: –Heavy sweating –Extreme thirst –Extreme weakness and fatigue –Giddiness, nausea, or headaches –Skin is cool, clammy, and moist, complexion pale or flushed –Body temperature is normal or slightly higher

17. First Aid Treatment for Heat Exhaustion Move victim into shade Loosen and remove clothing Cool the victim (wet cloth, spray mist) Have victim slowly drink water Elevate victim’s legs Medical Aid ASAP if victim not better

18. Heat Stroke Most serious, failure of the body’s internal mechanism to regulate it’s core temperature Cause: –Body temperature rises to fatal levels Symptoms: –Lack of sweat –Mental confusion, delirium, loss of concentration, convulsions or coma –Rapid pulse –A body temperature of 106°F or higher –Hot dry skin, which may be red, mottled, or blush –Convulsions, seizures, unconsciousness, or death can occur THE MOST SERIOUS STAGE OF HEAT ILLNESS

19. First Aid Treatment for Heat Stroke Call for emergency help ASAP Move victim into shade Loosen outer clothing Lower body temperature (massage body with ice or damp cloth) If victim is alert, have them slowly drink water

21. Heat Illness Signs & Symptoms Heavy sweating, cramps, rapid pulse, headache, nausea, vomiting Dry, red, hot skin, fainting, high body temperature, disoriented, confused NEED MEDICAL HELP Heat ExhaustionHeat Stroke

22. UCSD Campus Police From a campus phone 911 From a cell phone 858-534-HELP

23. Emergency Notification Procedure Tell the UCSD Police dispatcher that this is a heat related issue If ambulance is not readily available, go to the nearest Emergency Room –Thornton or Scripps Hospital on main campus –Hillcrest Notify your supervisor –Contact Workers’ Compensation at 822-2979 If hospitalized, notify the UCSD Police Dispatcher

24. http://blink.ucsd.edu/go/preventheatillness

25. In Review: Planning Procedures Weather monitoring- heat wave Acclimization Water Shade Training Recognizing heat illness symptoms Contacting emergency medical services Providing clear and precise directions

26. 534-HELP 911 (land line)

27. Why Should We Take Skin Protection Seriously? Skin Cancer is the most prevalent form of cancer in US UVR is the cause of premature aging, wrinkling, benign and pre-cancerous growths and at least 90% of all skin cancers Sun exposure accumulates over life time More than 1 MILLION new cases are diagnosed each year in US

28. FALSE Union Tribune, 6/23/09

30. A.Children under the age of 4 B.Anyone wearing sun protective clothing C.All of the above D.African-American and people with dark pigmented skin E.None of the above Union Tribune, 6/23/09

31. A.African-American and people with dark pigmented skin B.Children under the age of 4 C.Anyone wearing sun protective clothing D.All of the above E.None of the above Union Tribune, 6/23/09

32. 1 ounce…..enough to fill a shot glass

33. Basal Cell Carcinoma Affects 800,000 Americans each yearAffects 800,000 Americans each year Common on exposed parts of the bodyCommon on exposed parts of the body Common cancer in fair-skinned peopleCommon cancer in fair-skinned people

35. Squamous Cell Carcinoma Second most common skin cancerSecond most common skin cancer Afflicts 100,000 people/yearAfflicts 100,000 people/year Arises from the epidermis and can metastasizeArises from the epidermis and can metastasize Tumor appears in sun-exposed areasTumor appears in sun-exposed areas May be inheritedMay be inherited

37. Melanoma Most serious form of skin cancerMost serious form of skin cancer 42,000 new cases reported to ACS42,000 new cases reported to ACS Early stages, almost 100% curableEarly stages, almost 100% curable Advance stages, can be deadlyAdvance stages, can be deadly Malignant tumor originates in melanocytes (four types)Malignant tumor originates in melanocytes (four types) Heavily concentrates in molesHeavily concentrates in moles

39. Ways to Reduce Risk of Skin Cancer Wear Protective Clothing Wear Hats with Wide-brimmed Use Sunscreen on Exposed Skin (>SPF 15) Avoid Midday Sun Exposure (10am-4pm) Avoid Artificial UVR Sources Be Aware of Photosensitizing Medications Perform Skin Examination Each Month

40. A.Twice as much B.Fifteen times as much C.Thirty times as much D.Four percent more E.Fifteen percent more Union Tribune, 6/23/09

41. A.Twice as much B.Fifteen times as much C.Thirty times as much D.Four percent more E.Fifteen percent more Union Tribune, 6/23/09

43. Perform Monthly Skin Check monthly

44. Sunscreen Protection Factor Use products with SPF 15 or higher,that block UVA and UVB (titanium dioxide, zinc oxide, or avobenzone) Shake container well Apply generously and evenly (Ears too!) Apply 20 minutes before sun exposure Reapply every two hours or when wet Use sunscreen even on cloudy & cool days

45. Poikiloderma

46. What’s one of the most important body parts that needs sun protection?

47. Eye Protection UVB contributes to cataracts, vision- clouding clumps in the lens of the eye Wear sunglasses with labels meeting ANSI (95% UVB, 60% UVA) Choose large-frame wraparound style

48. In Conclusion: Heat Related Illnesses are Preventable Recognize early warning signs and take proactive action Skin Cancer Is Preventable Take Care of Your Skin by Using Good Skin Care Methods and Products EVERYDAY

49. References American Academy of Dermatology, Skin Cancer-An Undeclared Epidemic, 1994 National Institutes of Health Consensus Development Conference Statement, Sunlight, Ultraviolet Radiation, and the Skin, 1989 Ferrini R., Perlman M, Hill L. Skin Protection from Ultraviolet Light Exposure American College of Preventive Medicine Practice Policy Statement Consumer Reports, July 2000 The Skin Cancer Foundation: http://www.skincancer.orghttp://www.skincancer.org Cal/OSHA Reporter, June 14, 2002 & July 6 and 29, 2007 http://www.dir.ca.gov/DOSH/HeatIllnessInfo.html http://www.webmd.com/melanoma-skin-cancer/

50. Any Questions???