1. HEAT ILLNESS PREVENTION TRAINING KCAO safety training – May, 2015

2. The past few summers have shown that the risk of heat illness from high temperatures is one of the most serious challenges to the safety and health of workers. Effective May 1, 2015, the Occupational Safety & Health Administration (OSHA) and Cal/OSHA have made some changes to the Heat Illness Program Regulations, which this training will let you know about. WHY DO I NEED TO GO THROUGH THIS TRAINING?

3. 8 CCR 3395 – Heat Illness Prevention Applies to outdoor places of employment with heat illness potential Requirements: – Heat illness prevention training for supervisors and employees – Provision of water – Access to shade – Local procedures for heat illness prevention CAL/OSHA STANDARD:

4. Prior to working in warm weather (80+ degrees Fahrenheit), supervisors and employees shall be trained in the following: – Heat illness prevention measures – Environmental and personal risk factors for heat illness – The importance of consuming water throughout the work shift – The importance of acclimatization – Common signs/symptoms of heat illness – The importance of reporting signs/symptoms of heat illness to the supervisor – Emergency response procedures CAL/OSHA STANDARD - TRAINING:

5. The body normally cools itself by sweating. During hot weather, especially with high humidity, sweating isn’t enough. Body temperature can rise to dangerous levels if precautions are not taken, such as drinking water frequently and resting in the shade or air conditioning. Heat illnesses range from heat rash and heat cramps to heat exhaustion and heat stroke. Heat stroke requires immediate medical attention and can result in death. WHAT IS HEAT ILLNESS?

6. Just like we can’t let a car engine overheat or it shuts down, we don’t want our body to get too hot. Where does the heat come from that causes our bodies to overheat? WHAT IS HEAT ILLNESS?

7. Hot weather Humid weather Sun – you absorb more heat if you are in the sun Heat our bodies generate when we are physically active and doing hard work **Working outdoors, especially in hot and humid weather, being in the sun, and physically exerting ourselves is something we have to take seriously** WHAT IS HEAT ILLNESS?

8. Any worker exposed to hot and humid conditions is at risk of heat illness, especially those doing heavy work tasks or using bulky protective clothing and equipment. Some workers might be at greater risk than others if they have not built up a tolerance for hot conditions, including new workers, temporary workers, or those returning to work after a week or more off. This also includes everyone during a heat wave. WHO IS AFFECTED?

9. Industries most affected by heat- related illness are: – Construction – Trade, Transportation & Utilities – Agriculture – Building, Grounds Maintenance – Landscaping Services – Support activities for oil and gas operations Do you ever need to work outdoors? If so, how could the heat affect you in your position at KCAO? WHO IS AFFECTED?

10. Drink water – even before you are thirsty. Stay in the shade as much as possible and rest when you need it when working outdoors. Acclimatize slowly to the outdoors – gradually increase workloads outdoors and allow more frequent breaks for new workers or workers who have been away for a week or more to build a tolerance for working in the heat outdoors. Work with your supervisor to modify work schedules as necessary so you are not working outdoors during the hottest part of the day or in extreme heat conditions. HOW CAN HEAT ILLNESS BE PREVENTED?

11. Workers new to the heat or those who have been away from work and are returning can be most vulnerable to heat stress and they must be acclimatized. Acclimatization is defined as: – A physical change that builds tolerance to the heat, can be done by gradually increasing workload for new and returning workers – and for everyone during a heat wave. HOW CAN HEAT ILLNESS BE PREVENTED?

12. Plan for emergencies. – What do you do when you or another team member starts showing signs of heat illness? Notify your supervisor If your supervisor is not available, contact your supervisor’s manager or call the Human Resources Department If a person is non responsive or in other cases of emergency, call 911 (or 9-911 depending upon the phone system) and notify your Supervisor as soon as is practicable. HOW CAN HEAT ILLNESS BE PREVENTED?

13. Weather conditions – Temperature – Humidity – Air movement – Radiant heat (i.e., sunshine) – Conductive heat (i.e., ground) Higher intensity and/or duration of physical activity Personal Protective Equipment (PPE) and clothing can be a factor (i.e., Tyvek overalls, aprons, etc.) RISK FACTORS FOR HEAT ILLNESS

14. Poor physical condition* Age Degree of acclimatization Water consumption Some medications* Alcohol/drugs *Recommend checking with personal physician about heat illness risk PERSONAL RISK FACTORS FOR HEAT ILLNESS

15. The body tries to keep a constant internal temperature As internal temperature rises from activity, the body cools itself by: – Increasing blood flow to skin surface – Releasing sweat onto skin surface HOW THE BODY HANDLES HEAT

16. Heat exhaustion is caused by: – Excessive loss of water and salt through sweat Signs & Symptoms of Heat Exhaustion: – Headaches, dizziness, lightheadedness or fainting – Weakness and moist skin – Muscle cramps – Mood changes such as irritability or confusion – Upset stomach or vomiting HEAT EXHAUSTION:

17. Heat stroke is caused by: – Total breakdown of body’s cooling system Signs & Symptoms of Heat Stroke: – Sweating stops – skin is hot, red, and dry – Mental confusion, losing consciousness – Fainting – Seizure or convulsions Treat as a medical emergency! Heat Stroke can be life threatening. HEAT STROKE:

18. For any of the previously mentioned symptoms: – Immediately call 911 or 9-911 (depending on the phone system) – Follow the directions given by the emergency operator – Make sure the emergency responders can easily find the affected person – this may include having someone wait near the area where the emergency responders will be arriving EMERGENCY RESPONSE PROCEDURES:

19. While waiting for help: – Move person to cool area if needed – Give small cup of water (if conscious and not nauseous) – Loosen and/or remove clothing as appropriate – Fan and mist the person with water – Apply a water-soaked towel (or ice pack wrapped in a towel) to head and ice pack to armpits EMERGENCY RESPONSE PROCEDURES:

20. Contact supervisor immediately or as soon as is practicable Anyone with symptoms must never be sent home or left unattended without a medical evaluation – A medical evaluation can be completed only by certified medical staff (i.e., EMT, Paramedic, Emergency Room staff, Kings Industrial Medical Center staff, etc.) Work with your supervisor to complete a workers’ compensation injury report and forward to Human Resources. EMERGENCY RESPONSE PROCEDURES:

21. If employees will be working outdoors, without immediate access to a cooled building, supervisors are responsible for assessing weather conditions – Weather forecasts http://nws.noaa.gov California Dial-A-Forecast – Hanford 559-584-8047 Prior to each workday employees will be working outdoors, the forecasted temperature and humidity will need to be reviewed and compared against the National Weather Service Heat index to evaluate the risk level for heat illness. WORK PLANNING AND SUPERVISION:

22. A determination will be made of whether or not workers will be exposed at a temperature and humidity characterized by the Heat Index Chart as: – Caution – Extreme Caution – Danger – Extreme Danger It is important to note that the temperature at which these warnings occur must be lowered as much as 15 degrees if the workers under consideration are going to be working in direct sunlight. WORK PLANNING AND SUPERVISION:

23. NOAA/NWS HEAT INDEX CHART:

24. The heat index values were devised for shady, light wind conditions, and exposure to full sunshine can increase heat index values by up to 15° Fahrenheit. To account for solar load, added precautions are recommended. IMPORTANT NOTE ABOUT THE NOAA’S HEAT INDEX:

25. The U.S. National Oceanographic and Atmospheric Administration (NOAA) developed the heat index system. The heat index combines both air temperature and relative humidity into a single value that indicates the apparent temperature in degrees Fahrenheit, or how hot the weather will feel. The higher the heat index, the hotter the weather will feel, and the greater the risk that outdoor workers will experience heat-related illness. NOAA issues heat advisories as the heat index rises. To learn more about the heat index, visit NOAA’s website. http://nws.noaa.govhttp://nws.noaa.gov ABOUT THE HEAT INDEX:

26. The "heat index" is a single value that takes both temperature and humidity into account. The higher the heat index, the hotter the weather feels, since sweat does not readily evaporate and cool the skin. The heat index is a better measure than air temperature alone for estimating the risk to workers from environmental heat sources. WHAT IS A HEAT INDEX:

27. The heat index can be used to help determine the risk of heat-related illness for outdoor workers, what actions are needed to protect workers, and when those actions are triggered. Depending on the heat index value, the risk for heat-related illness can range from lower to very high to extreme. As the heat index value goes up, more preventive measures are needed to protect workers. Heat index values are divided into four bands associated with four risk levels. For more guidance from OSHA about the heat index go to: – https://www.osha.gov/SLTC/heatillnes s/heat_index/about.html https://www.osha.gov/SLTC/heatillnes s/heat_index/about.html USING THE HEAT INDEX:

28. Relative humidity is a measure of the amount of moisture in the air. Sweat does not evaporate as quickly when the air is moist as it does in a dry climate. Since evaporation of sweat from the skin is one of the ways the human body cools itself on a hot day, high humidity reduces our natural cooling potential and we feel hotter. Low humidity can also be a problem for outdoor workers in hot, desert-like climates. Sweat evaporates very rapidly in low humidity, which can lead to severe dehydration if a person does not drink enough water throughout the day. WHY HUMIDITY MATTERS:

29. Once a determination has been made, appropriate steps must be taken to prevent heat illness and maintain compliance with Cal/OSHA regulations. Follow the procedures outlined next and take steps to limit the exposure an employee has to heat wave and high heat work outdoors. AFTER MAKING A DETERMINATION USING THE HEAT INDEX :

30. Supervisors should determine if temperatures will be 80 degrees Fahrenheit or higher. At or above 80 degrees Fahrenheit, shade structures must be made easily accessible to workers at all times they are working outdoors. Below 80 degrees, shade structures must be made available upon request. Fresh, pure and suitably cool water must be available to all workers, especially in the shaded area. Supervisors must regularly monitor employees for alertness and signs/symptoms of heat illness. PROCEDURES FOR 80 DEGREES FAHRENHEIT OR HIGHER DAYS:

31. Shade is defined as a blockage of direct sunlight. Blockage is always sufficient when objects do not cast a shadow in the shaded area. An enclosed area used to provide shade must allow cooling at least comparable to the cooling that would be provided in a shaded unenclosed area in the same location. Shade must be easy for employees to reach and its location must not deter or discourage access or use. Cool-down periods should be encouraged and employees are allowed to take a rest break to cool down to protect themselves from overheating. ACCEPTABLE SHADE STRUCTURES:

32. Workers should not have to encounter obstacles or hazards or unreasonably unpleasant conditions to reach the shade or while resting in it. For example, employees should not have to cross traffic or waterways to reach the shade nor should it be located next to portable toilet facilities or where employees would sit on wet or muddy ground or come in contact with branches, brush or thorns. The shaded area must let employees assume a comfortable posture and must not cause exposure to another health or safety hazard. Nonagricultural employers may provide cooling measures other than shade if they can demonstrate that the alternative is at least as effective as shade. ACCEPTABLE SHADE STRUCTURES:

33. Shade structures cannot be any of the following: ACCEPTABLE SHADE STRUCTURES:

34. Heat Wave means any day in which the predicted high temperature for the day will be at least 80 degrees Fahrenheit and at least ten degrees Fahrenheit higher than the average high daily temperature in the preceding five days. Outdoor work will be limited or reschedule. Before starting work outdoors, a short meeting will need to occur reviewing the heat illness prevention procedures, the weather forecast and emergency response. Each employee working outdoors will be assigned a “buddy” to be on the lookout for signs and symptoms of heat illness and the ensure that emergency procedures are initiated when someone displays possible signs of heat illness. HEAT WAVE PROCEDURES:

35. When temperatures are expected to, or do exceed 95 degrees Fahrenheit, High Heat Procedures must be implemented. Effective communications by voice, direct observation, mandatory buddy system, or electronic means will be maintained, so that employees at the outdoor worksite area can contact a supervisor when necessary. If the supervisor is unable to be near the outdoor workers (to observe them or communicate with them), then an electronic device, such as a cell phone or text messaging device, may be used for this purpose if reception in the area is reliable. HIGH HEAT DAY PROCEDURES (95  F+):

36. Frequent communication will be maintained with employees working by themselves or in smaller groups (keep tabs on them via phone or two way radio if a supervisor is not able to visibly see them or near enough to speak with them), to be on the lookout for possible symptoms of heat illness. The employee(s) will be contacted regularly and as frequently as possible throughout the day, since an employee in distress may not be able to summon help on his or her own. HIGH HEAT DAY PROCEDURES (95  F+):

37. Effective communication and direct observation for alertness and/or signs and symptoms of heat illness will be conducted frequently when employees are working outside in high heat. When the supervisor is not available, a designated alternate responsible person must be assigned, to look for signs and symptoms of heat illness. If a supervisor, designated observer, or any employee reports any signs or symptoms of heat illness in any employee, the supervisor or designated person will take immediate action commensurate with the severity of the illness (refer to the Emergency Response Procedure slides). HIGH HEAT DAY PROCEDURES (95  F+):

38. Employees will be reminded constantly throughout the outdoor work shift to drink plenty of water and take a preventative cool-down rest break when needed of no less than five minutes. HIGH HEAT DAY PROCEDURES (95  F+):

39. When working outdoors when the temperature reaches 80 degrees Fahrenheit or higher: – Drink water every 15 minutes, even if you are not thirsty. Stanford Medical Center recommends consuming at least four cups of water per hour for the entire shift. – Rest in the shade to cool down. – Wear a hat and light colored clothing. – Learn the signs of heat illness and what to do in an emergency. – Keep an eye on fellow workers. – “Easy does it” on your first days of work in the heat. You need to get used to it. LET’S RECAP HOW TO PREVENT HEAT RELATED ILLNESS & FATALITIES:

40. Supervisors and team members should work together to create a schedule that allows everyone to get used to the heat gradually. This is called acclimatization. Limit outdoor work activities during times of a heat wave and high heat. BE AWARE: Working in full sunlight can increase heat index values by 15 degrees Fahrenheit. Keep this in mind and plan additional precautions for working in these conditions. Keep communication open and work together as a team to keep everyone safe! LET’S RECAP HOW TO PREVENT HEAT RELATED ILLNESS & FATALITIES:

41. REMEMBER THESE THREE SIMPLE WORDS:

42. If you have questions, please discuss them with your Supervisor. QUESTIONS?

43. PLEASE COMPLETE THE SHORT QUIZ AND SIGN THE ACKNOWLEDGEME NT FORM, THEN GIVE TO YOUR SUPERVISOR WHO WILL FORWARD IT TO THE HUMAN RESOURCES DEPARTMENT