On a jobsite in Kingsville, Texas, in August 2013, a worker was mixing gypsum concrete in preparation for gypcrete installation on an apartment building. It’s not a particularly taxing job, but he was doing it in direct sunlight. “He wasn’t training or doing anything that involved a lot of lifting or climbing,” says Holly Webster, director of administration at Texas-based KWA Construction, which served as the general contractor on the job. (KWA would not release further information on either the worker or subcontractor.) The man, in his 20s, had just transferred from New Mexico, and he wasn’t used to the heat and humidity of a Texas summer. While he’d had some water that day, he also drank some caffeine-packed energy drinks.
At one point the worker told the jobsite foreman he did not feel well, so the foreman had him rest in a shaded area. No one recognized how bad off he was, Webster says. The subcontractor had heat stroke, from which he ultimately died.
Unfortunately, this subcontractor isn’t alone. From 2008 to 2014, the U.S. Department of Labor and OSHA recorded 109 heat fatalities in the U.S., though that number doesn’t include incidents reported to the Bureau of Labor Statistics that fell outside federal and state OSHA jurisdiction. In 2014 alone, 2,630 workers suffered from heat illness and 18 died from heat stroke and related causes on the job.
What to Watch For
Heat-related illness comes, broadly, in four forms, moving from less dangerous maladies such as heat rash or heat cramps to severe and possibly fatal heat exhaustion and heat stroke.
Basic treatments for mild heat-related issues may seem obvious: If a worker is having muscle spasms or pain, he or she should rest in a cool, shady area and drink water or other non-caffeinated, non-alcoholic drinks. If a worker is experiencing heavy sweating, headache, dizziness, nausea, or vomiting, he or she could be suffering from heat exhaustion. They still should be moved to a shaded or air-conditioned area and given the same kinds of cool drinks, but also should be cooled down with cold compresses and ice packs; a trip to a hospital should be considered.
If a worker is confused, has fainted, or is having a seizure, heat stroke could be the cause, says Olveen Carrasquillo, chief of the University of Miami’s internal medicine division. His advice is to call 911, and then, if possible, lower the worker’s body temperature with an ice bath until the ambulance arrives.
There’s no way to know when jobsite conditions deteriorate to the point at which workers could be in harm’s way. “It’s the combination of heat and humidity,” Carrasquillo says. A certain degree of risk can be determined through the use of a heat index, though Carrasquillo suggests looking at the wet bulb globe temperature (WGBT), which factors in temperature, humidity, wind speed, sun angle, and cloud cover. It’s been used by the U.S. military for more than 50 years to help prevent heat illnesses during basic training.
You can calculate WGBT through a formula, or by buying a monitoring device (most cost under $300). But tracking the WGBT alone doesn't account for another important risk factor: whether a worker is used to working in high heat and humidity. “They should have at least two weeks to get used to working in these conditions,” Carrasquillo says.
OSHA Guidance
While OSHA doesn’t have regulations regarding heat and humidity, spokesperson Kimberly Darby says both are covered under the “general duty clause” that employers are required to provide their employees with a place of employment that is free from hazards that could cause death or serious injury.
“This includes heat-related hazards that are likely to cause death or serious bodily harm,” Darby says. While there are no required number of breaks for workers in these conditions, OSHA recommends that employers ensure employees have plenty of cool water. Workers should be encouraged to drink water every 15 minutes, and the employer should “provide or ensure that fully shaded or air-conditioned areas are available for resting and cooling down,” she adds.
OSHA has myriad heat stress resources on its website, ranging from detailed guides to an easy-to-digest “Quick Card” that includes risk factors, symptoms, and preventive measures.
The agency also created a Heat Safety Tool app that’s available on iOS and Android platforms in both English and Spanish. The app allows anyone to calculate the heat index for a jobsite and the risk level for outdoor workers. KWA provides download instructions and information on the functionality of the OSHA app to all of its operations employees. “KWA supplies iPads to almost all field operations employees, which they use on a daily basis, so we encourage them to install it there,” Webster says.
Preventive Measures
Just because OSHA doesn’t have a regulation specific to heat stress doesn’t mean contractors are off the hook, says Ed Beaulieu, director of field operations for New Jersey–based Safegate Safety Solutions. “They still expect you to protect your employees,” he notes. “You can’t use ‘there is no standard’ as a excuse.”
Along with OSHA’s recommendations, Beaulieu suggests altering work hours, if possible, so workers are not in the sun during the hottest part of the day. That practice might run afoul of local noise ordinances, especially in congested areas, but it can work on some sites. Contractors also can ensure workers take enough breaks and, especially on sites without shade, provide “a cooling area with a tent set up so that they can get out of the sun,” Beaulieu says. Adding fans, either regular or misting, in those areas can help, too.
The OSHA Quick Card is a resource that Maracay Homes often has used to disseminate information about heat stress. For the Arizona-based company, heat is a constant, but in the summer months, it’s a real threat with temperatures spiking up to 115 degrees on jobsites that may have no cloud cover and very little wind.
“People can get complacent, even here in Arizona where we’re used to the sunshine,” says Charles Holinka, area manager at Maracay. “It’s not like a thunderstorm where it rolls in and everybody knows to get out of the way. It’s one of those things that creeps up on you when you’re least expecting it.”
The company designates an annual Heat Awareness Month. This year’s month was May, during which the company had its teams focus a weekly “toolbox talk” between project managers and contractors on the symptoms of heat stress and measures that can be taken to prevent it. Contractors must sign off on paperwork to let upper management know they participated in the safety talk.
During the second week of May—when this year temperatures spiked into the 100s—Maracay passed out an OSHA Quick Card in either English or Spanish along with Gatorade. The workers were encouraged to keep the semi-laminated cards in an easily accessible place. The following week, Maracay supplied about 300 MiraCool bandanas for use on site. The bandanas include pellets that stay cold and can help cool down a body when worn around the neck.
Lessons Learned
After the jobsite heat stroke fatality in 2013, KWA Construction ramped up efforts to prevent future heat illness incidents. “One of the biggest lessons we’ve learned as an organization is that one-time, single-event training just isn’t sufficient,” Webster says.
Understanding the heat index and various types of heat illness is now part of training for all KWA employees, even if they’re not working in the field. The company uses biannual management meetings and quarterly project superintendent meetings to review the topic, and management mandates that heat-related illness, prevention, and treatment be covered during jobsite safety meetings at a minimum of once a month during warmer months.
KWA also, as of 2016, provides jobsite heat kits that include safety signage, items to help keep workers cool, and supplies to help treat anyone suffering from heat illness. The contractor also hosts summer “cool down” events to promote taking breaks in the shade. If there is no shade, areas are designated for rest breaks, Webster says, such as a trailer, an already-constructed building, or a parking garage. If those aren’t options, KWA will set up tents.
In hopes of preventing future heat-related illness on its jobsites, KWA educates its staff about what happened to the subcontractor who died from heat stroke in 2013: why he’d been susceptible even though he was young and not engaged in a strenuous task; how his death could have been avoided; and about who he was, both personally and professionally.
“It starts to sink in that these aren’t just workers,” Webster says. “These are people who have other people who are depending on them. This is why we really need to be vigilant.”