Issue 76 May 2016

Health Advisory CenterHealth Advisory CenterHealth Advisory CenterHealth Advisory Center

The e-bulletin is a monthly service provided by CEDARS – Jebel Ali International Hospital in order to raise awareness for

various health issues.

CEDARS - Jebel Ali International Hospital, Dubai, UAE. Tel: 04-881-4000 Fax: 04-881-4001

Heat StressHeat StressHeat StressHeat Stress Workers who are exposed to extreme heat or work in hot

environments may be at risk of heat stress. Exposure to

extreme heat can result in occupational illnesses and injuries.

Workers should be aware of early signs and symptoms such as

excessive sweating, dizziness, and nausea. Heat can also in-

crease the risk of injuries in workers as it may result in sweaty

palms, fogged-up safety glasses, and dizziness. Burns may also

occur as a result of accidental contact with hot surfaces or

steam. If heat stress is not recognized and treated in the early

stages, it can have serious effects on the body, such as heat

cramps, heat exhaustion, or heat stroke, which can be life-

threatening.

Workers at risk of heat stress include outdoor workers and

workers in hot environments such as firefighters, bakery

workers, farmers, construction workers, miners, boiler room

workers, factory workers, and others. Workers at greater risk

of heat stress include those who are 65 years of age or older,

are overweight, have heart disease or high blood pressure, or

take medications that may be affected by extreme heat.

Workers at greater risk of heat stress include those who are

65 years of age or older, are overweight, have heart disease

or high blood pressure, or take medications that may be

affected by extreme heat.

Prevention of heat stress in workers is important.

Employers should provide training to workers so

they understand what heat stress is, how it affects

their health and safety, and how it can be prevented.

Control of Heat Stress

Engineering controls might include those that:

− Increase air velocity. − Use reflective or heat-absorbing shielding or

barriers.

− Reduce steam leaks, wet floors, or humidity.

Employers should reduce workplace heat stress by

implementing engineering and work practice controls.

Page 2 Heat Stress

CEDARS - Jebel Ali International Hospital, Dubai, UAE. Tel: 04-881-4000 Fax: 04-881-4001

Work practice recommendations include the following:

− Limit time in the heat and/or increase recovery time spent in a cool environment.

− Reduce the metabolic demands of the job. − Use special tools (i.e., tools intended to minimize manual strain).

− Increase the number of workers per task.

− Train supervisors and workers about heat stress. − Implement a buddy system where workers observe each other for signs of heat

intolerance. − Require workers to conduct self-monitoring and create a work group (i.e., work-

ers, a qualified healthcare provider, and a safety manager) to make decisions on self-monitoring options and standard operating procedures.

− Provide adequate amounts of cool, potable water near the work area and en-

courage workers to drink frequently. − Implement a heat alert program whenever the weather service forecasts that a

heat wave is likely to occur. − Institute a heat acclimatization plan and increase physical fitness.

Train workers before hot outdoor work begins. Tailor training to cover work-

site-specific conditions.

Employers should provide a heat stress training program for all workers and supervisors about the following:

− Recognition of the signs and symptoms of heat-related illnesses and ad-

ministra-tion of first aid.

− Causes of heat-related illnesses and the procedures that will mini-mize the risk, such as drinking enough water and monitoring the color and

amount of urine output. − Proper care and use of heat-protective clothing and equipment and the

added heat load caused by exertion, clothing, and per-sonal protective equipment.

− Effects of no occupational factors (drugs, alcohol, obesity, etc.) on

tolerance to occupational heat stress. − The importance of acclimatization.

− The importance of immediately reporting to the supervisor any symptoms or signs of heat-related illness in themselves or in coworkers.

Training

Hydration Employers should provide the means for appropriate hydration of workers.

− Water should be potable, <15°C (59°F), and made accessible near the work area.

− Estimate how much water will be needed and decide who will obtain

and check on water supplies. − Individual, not communal, drinking cups should be provided.

− Encourage workers to hydrate themselves.

Workers should drink an appropriate amount to stay hydrated.

− During prolonged sweating lasting several hours, drink sports drinks

containing balanced electrolytes. − Avoid alcohol and drinks with high caffeine or sugar.

− Generally, fluid intake should not exceed 6 cups per hour.

− If in the heat <2 hours and involved in moderate work activities, drink 1 cup (8 oz.) of water every 15–20 mins.

Page 3 Heat Stress

CEDARS - Jebel Ali International Hospital, Dubai, UAE. Tel: 04-881-4000 Fax: 04-881-4001

Rest Breaks Employers should ensure and encourage workers to take appropriate rest

breaks to cool down and hydrate.

− Permit rest and water breaks when a worker feels heat discomfort. − Modify work/rest periods to give the body a chance to get rid of excess

heat. − Assign new and unacclimatized workers lighter work and longer, more

frequent rest periods.

− Shorten work periods and increase rest periods: − As temperature, humidity, and sunshine increase.

− When there is no air movement. − If protective clothing or equipment is worn.

− For heavier work.

Heat Stress - Heat Related Illness

Heat Stroke Symptoms Symptoms of heat stroke include:

− Confusion, altered mental status, slurred speech

− Loss of consciousness (coma) − Hot, dry skin or profuse sweating

− Seizures

− Very high body temperature − Fatal if treatment delayed

First Aid Take the following steps to treat a worker with heat stroke:

− Call 911 for emergency medical care. − Stay with worker until emergency medical services arrive.

− Move the worker to a shaded, cool area and remove outer clothing.

− Cool the worker quickly with a cold water or ice bath if possible; wet the skin, place cold wet clothes on skin, or soak clothing with cool water.

− Circulate the air around the worker to speed cooling. − Place cold wet clothes or ice on head, neck, armpits, and groin; or soak the clothing with cool water.

Heat Exhaustion Symptoms Symptoms of heat exhaustion include:

− Headache

− Nausea − Dizziness

− Weakness

− Irritability − Thirst

− Heavy sweating − Elevated body temperature

− Decreased urine output

First Aid Treat a worker suffering from heat exhaustion with the following:

− Take worker to a clinic or emergency room for medical evaluation and treatment. − If medical care is unavailable, call 911.

− Someone should stay with worker until help arrives.

− Remove worker from 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 head, face, and neck with cold water. − Encourage frequent sips of cool water.

Page 4 Heat Stress

CEDARS - Jebel Ali International Hospital, Dubai, UAE. Tel: 04-881-4000 Fax: 04-881-4001

Rhabdomyolysis

Symptoms Symptoms of rhabdomyolysis include:

− Muscle cramps/pain

− Abnormally dark (tea or cola colored) urine − Weakness

− Exercise intolerance

− Asymptomatic

First Aid Workers with symptoms of rhabdomyolysis should:

− Stop activity. − Increase oral hydration (water preferred).

− Seek immediate care at the nearest medical facility.

− Ask to be checked for rhabdomyolysis (i.e., blood sample analyzed for creatine kinase)

Heat Syncope Symptoms Symptoms of heat syncope include: − Fainting (short duration) and dizziness

− Light-headedness during prolonged standing or suddenly rising from a sit-ting or lying position

First Aid Workers with heat syncope should:

− Sit or lie down in a cool place, slowly drink water, clear juice, or a sports drink.

Heat Cramps Symptoms

− Muscle cramps, pain, or spasms in the abdomen, arms, or legs

First Aid Workers with heat cramps should:

− Avoid salt tablets.

− Drink water and have a snack and/or carbohydrate-electrolyte replacement liquid (e.g., sports drinks) every 15

to 20 minutes. − Get medical help if the worker has heart problems, is on a low sodium diet, or if cramps do not subside within

1 hour.

Heat Rash Symptoms Symptoms of heat rash include:

− Looks like red cluster of pimples or small blisters − Usually appears on the neck, upper chest, groin, under the breasts, and in

elbow creases

First Aid Workers experiencing heat rash should:

− When possible, a cooler, less humid work environment is best treatment. − Keep rash area dry.

− Powder may be applied to increase comfort.

− Ointments and creams should not be used.

Dr. Farzad Ghaedi has more than 7 years experience as a medical doctor in the UAE. He had

worked in several hospitals such as Al Kuwaiti Hospital, Al Qasimi Hospital and Russian Hospital.

His experience includes working in Accident & Emergency Department, General Surgery and

Internal Medicine. Dr. Ghaedi received his MBBS in St. Petersburg, Medical State of Pavlov I.P.

on 2003.

He also speaks several languages such as English, Persian, Arabic, Urdu, Russian, and German.

Dr. Farzad Ghaedi

GP - Occupational Health

Page 5 Heat Stress

CEDARS - Jebel Ali International Hospital, Dubai, UAE. Tel: 04-881-4000 Fax: 04-881-4001

Established in 1999, CEDARS – Jebel Ali International Hospital is a full-fledged multi-specialty hospital offering services

ranging from Pediatrics to Occupational Health, Laparoscopic Surgery to Internal Medicine. The Hospital is equipped with ICU for medical and surgical emergencies, with two major and one minor operation theatres as well as with fully

equipped Laboratory and Radiology departments.

The CEDARS Training Center is a registered training provider with qualified and dedicated instructors offering a wide

range of courses for both individuals and companies. The training center is committed to improving health and safety at home, at any public place or in the workplace providing classes in Basic First Aid and Basic Life Support through an

alignment with the American Hospital Dubai, an American Heart Association (AHA) International Training Center.

Further attached to the hospital are the 24-hour-pharmacy, the CEDARS Clinic and Dr. Adnan Kaddaha Clinic, opening

soon in Dubai Motor City. Projects to expand the hospital structure and add more services that enable CEDARS Jebel Ali

International Hospital to become a comprehensive healthcare provider are under way.

About CEDARS - Jebel Ali International Hospital