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First Aid for Illnesses Caused by Heat Stress

The planet is getting hotter. NASA data shows “a long-term warming trend due to human activities.”[1] That trend increases the problems associated with environmental heat exposure, particularly among workers who don’t have the luxury of avoiding it. Health problems caused by heat stress can range from mild to severe, and account for dozens of deaths each year, per the U.S. Bureau of Labor Statistics. Of the 57 U.S.-based workers who died of heat-related illnesses in 2019, 41.9% were engaged in construction, repair or cleaning activities and 15.7% died while conducting material handling operations. Given the aging of the American workforce, it’s worth noting that 16.6% of the fatalities involved workers in the 55–64 age range.[2]

Prevention is, of course, the best approach when it comes to protecting workers from heat-related illnesses. However, if one has occurred, it’s important to be able to act quickly and effectively to mitigate the effects on an employee’s health.

Here, from the National Institute for Occupational Safety and Health (NIOSH), is a rundown on the types of heat-related illnesses and the appropriate first aid to render until professional help arrives or – in milder cases – the symptoms subside.

Heat stroke is the most serious heat-related illness. It occurs when the body can no longer control its temperature: the body’s temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. When heat stroke occurs, the body temperature can rise to 106°F or higher within 10 to 15 minutes. Heat stroke can cause permanent disability or death if the person does not receive timely emergency treatment.

Heat stroke symptoms:

  • Confusion, altered mental status, slurred speech
  • Loss of consciousness (coma)
  • Hot, dry skin or profuse sweating
  • Seizures
  • Very high body temperature

First aid for heat stroke:

  • Call 911 for emergency medical care.
  • Move the worker to a shaded, cool area and remove outer clothing.
  • Cool the worker quickly, using the following methods:
  • With a cold water or ice bath, if possible
  • Wet the skin
  • Place cold wet cloths on the skin
  • Soak clothing with cool water
  • Circulate the air around the worker to speed cooling.
  • Place cold wet cloths or ice on the head, neck, armpits and groin; or soak the clothing with cool water.

Heat exhaustion is the body’s response to an excessive loss of water and salt, usually through sweating. People who are elderly, have high blood pressure or who work in hot environments are at high risk for heat exhaustion.

Heat exhaustion symptoms:

  • Headache
  • Nausea
  • Dizziness
  • Weakness
  • Irritability
  • Thirst
  • Heavy sweating
  • Elevated body temperature
  • Decreased urine output

First aid for heat exhaustion:

  • Take worker to a clinic or emergency room for medical evaluation and treatment.
  • Call 911 if medical care is unavailable.
  • Remove the worker from the hot area and give liquids to drink.
  • Remove unnecessary clothing, including shoes and socks.
  • Cool the worker with cold compresses or have the worker wash their head, face and neck with cold water.
  • Encourage frequent sips of cool water.

Rhabdomyolysis causes the rapid breakdown, rupture and death of muscle. When muscle tissue dies, electrolytes and large proteins are released into the bloodstream. This can cause irregular heart rhythms, seizures and damage to the kidneys.

Rhabdomyolysis symptoms:

  • Muscle cramps/pain
  • Abnormally dark (tea or cola-colored) urine
  • Weakness
  • Exercise intolerance
  • Asymptomatic

First aid for rhabdomyolysis:

  • Have the worker stop activity and drink more liquids (water preferred)
  • Have the worker seek immediate care at the nearest medical facility and
  • Ask to be checked for rhabdomyolysis (i.e., blood sample analyzed for creatine kinase).

Heat syncope is a fainting episode or dizziness that usually occurs when standing for too long or suddenly standing up after sitting or lying. Factors that may contribute to heat syncope include dehydration and lack of acclimatization.

Symptoms of heat syncope:

  • Fainting (short duration)
  • Dizziness
  • Light-headedness from standing too long or suddenly rising from a sitting or lying position

First aid for heat syncope:

  • Have the worker sit or lie down in a cool place, and
  • Slowly drink water, clear juice or a sports drink.

Heat cramps usually affect workers who sweat a lot during strenuous activity. This sweating depletes the body’s salt and moisture levels. Low salt levels in muscles cause painful cramps. Heat cramps may also be a symptom of heat exhaustion.

Heat cramps symptoms are muscle cramps, pain or spasms in the abdomen, arms or legs.

First aid for heat cramps:

  • Have the worker drink water and have a snack or a drink that replaces carbohydrates and electrolytes (such as sports drinks) every 15 to 20 minutes, and
  • Avoid salt tablets.
  • Get medical help if the worker:
  • Has heart problems.
  • Is on a low sodium diet.
  • Has cramps that do not subside within 1 hour

Heat rash is a skin irritation caused by excessive sweating during hot, humid weather.

Heat rash symptoms: Red clusters of pimples or small blisters that usually appears on the neck, upper chest, groin, under the breasts and in elbow creases

First aid for heat rash:

  • Have employee work in a cooler, less humid environment, if possible.
  • Keep the rash area dry.
  • Apply powder to increase comfort.
  • Don’t use ointments and creams. WMHS



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