Heat Illness Prevention for Filipino Workers

by: Rosanna M. Tubelonia

OSH Trainer and Accredited Safety Practitioner

Summer is just around the corner. Temperatures are expected to soar. The Philippines is a tropical country where we say we are “used” to the heat, but with climate change as the buzzword these days, maybe it is high time to amend this attitude, especially for our workers who mostly work outdoors or on the field. Remember that the industries or sectors involved, such as construction, ship-building, power generation and the service sectors of transportation, and telecommunication are our country’s current engines for economic growth.

How Heat Affects the Human Body

In its mildest form, heat makes us cross and sluggish. We may also experience “milaria rubria”, a dysfunction of the body’s sweat glands, locally known as “bungang-araw” which are easy enough to treat by cooling down the body with the use of soap and water. Or in the case of children, dabbing the body with corn starch (“gawgaw”) so sweat stays and not drip off the body.

However, in more oppressive heat, the body senses danger and kick-off procedures to cool the body down. The heart beats faster to increase the flow of blood to the skin, trying to keep critical internal organs from overheating. But if the body’s core temperature continues to rise, drastic measures kick in. Sweat starts dripping — then pouring — from the glands so evaporation can cool the body. But if humidity leaves the sweat with no place to go and it simply drips off the skin, the internal temperature will skyrocket, leading eventually to organ damage (more often than not, the heart) and death.

Research has also indicated that for every one-degree Celsius rise in core temperature, a typical person's heartbeat goes up 30 beats per minute. Most vulnerable therefore to heat stress are those with heart problems. Another at risk group are those who suffer from diabetes, in part because their nerve fibers don't signal the blood vessels to dilate. This could decrease the amount of blood brought to the skin's surface to dissipate heat. Other evidence also suggests people with diabetes may have a reduced ability to sweat.

Two Types of Heat Illness

There are two types of heat illness, as follows:The first type is Heat Exhaustion- the mildest form of heat-related illness. It can develop in those exposed to high temperatures over several days who haven't adequately replaced the water and salt they lose when they sweat. Commonly, an affected worker may experience: 1) dizziness; 2) headache; 3) sweaty skin; 4) fast heart beat; 5) nausea, vomiting; 6) weakness; and 7) cramps.

If not treated, the condition will progress to the second type which is Heat Stroke. This occurs when the body can't regulate its internal temperature — when the sweating mechanism fails and the body is unable to cool down. When the body's temperature rises past 103 degrees, cell damage can occur and organs begin to shut down. Enzymes in our cells work at certain temperatures, and if it's too hot, the cells will actually degrade when they reach a critical temperature. As an example, the intestines may become more permeable, allowing harmful bacteria to get into the bloodstream. Victims typically may show any or a combination of the following symptoms: 1) red, hot dry skin; 2) fever; 3) confusion; 4) fainting and finally, 5) convulsions leading to death if not immediately recognized and treated. It must also be remembered that people react differently and may not have the same set of symptoms. Immediate help should be sought if a worker suspects that he or she is now suffering from the extreme effects of heat.

How to Stay Safe and Healthy in Warm Conditions

For workers, some of the practical tips are to:

Drink water even if one is not thirsty (preferably after every 15 minutes)- which means that workers should always carry in their person, water canteens or other portable water containers;
Watch out for each other- some workers may be more vulnerable to heat or may totally disregard symptoms while absorbed at work. It remains for the co-workers to look out for signs and symptoms of either heat exhaustion or heat stroke on each other;
Wear head protection for heat, as well as light-colored clothing which covers body areas most exposed to the sun;
Rest in the shade during breaks or when the heat becomes unbearable;
Know your location at the worksite so that help can be easily summoned should the need arise for immediate medical treatment.

Employers on the other hand, are enjoined to:

Provide potable water- water facilities or water stations should be scattered in strategic locations for workers to obtain or replenish their water supply;
Provide shade and rest facilities again in strategic locations so workers do not seek shade under vehicles or other unsafe locations;
Trainings and information on the effects, prevention and recognition of heat illnesses; and
Emergency plans for dealing with heat-related concerns, including needed medical provisions at the company clinic.

Training and Information Components

Training on the topic should be simple and easy to understand for the workers. Toolbox meetings, of 15 minute duration, can be an ideal vehicle to conduct an awareness campaign for the workers. Posters and daily checklists can further remind workers on the precautions to be taken. Use of pictures or other illustrations can strengthen message of prevention to many workers. Topic sessions are recommended to include:

Session 1: Health effects of heat;
Session 2: How to respond to symptoms; and
Session 3: Preventing heat illness.

On Drinking Water More Often and other Helpful Points

Workers outdoors or in the field, should generally drink water even if they do not feel thirsty. Drinking small amounts more frequently rather than large amounts less often is also recommended. On the concern that drinking water can lead to more toilet breaks, drinking small amounts frequently will normally eliminate such concern as water intake will mostly be sweated off. Avoid coffee, and alcoholic beverages since these can dehydrate, thus putting further stress to the heart. Sports drinks are also to be avoided because of their high sugar content. When at home or after work hours, drink more water to help the body recover from the heat exposure during the day. For hygiene and comfort purposes, it is also advisable to take a bath or a shower when completely rested to further allow the body to cool down and to slough off bacteria that feed on body sweat. In higher than expected temperatures, employers are enjoined to increase the number of rest breaks and provide more shades and shelters to workers. Newly-hired workers should also be allowed to gradually be acclimatized to the heat by gently easing them to field work rather than thrusting them immediately to highly warm work conditions.

Let’s prevent heat illnesses NOW! More than the economic importance of these workers to the country, it is hoped that with these proactive approaches, we will never experience the tragedy of workers dying due to heat as this can be easily prevented. We owe this to our workers.