Heat Stroke In Construction: A Dangerous And Underreported Issue

Construction workers are at an elevated risk of heat stroke due to the strenuous nature of their work, high-temperature work conditions, and a changing climate. Heat stroke is the most severe heat-related illness, and it can be fatal or cause permanent disability. From 1992 to 2016, 285 construction workers in the United States died from heat-related causes, accounting for more than a third of all occupational heat-related deaths in the country. Construction workers in the southern United States, the Middle East, Asia, Latin America, and Africa are regularly exposed to extremely high temperatures with long working hours and may have limited or no access to shade or water. The risk of heat-related illnesses is increased by the fact that little to no regulations are present and/or enforced to protect these workers.

Heat stress is a combination of worker's exposure to heat from physical activity, environmental factors, and clothing

Heat stress is a combination of workers' exposure to heat from physical activity, environmental factors, and clothing. Physical activity is a major source of heat build-up in the body, with about 75% of the energy used for physical work converted into heat. The more strenuous the physical activity, the more internal heat the body produces. Heat stress can be caused by environmental and personal risk factors. Environmental risk factors include working in hot air, direct sunlight, or lack of effective shading. Personal risk factors include degree of acclimatization, caffeine consumption, use of prescription medications, and age.

The type of clothing worn can also impact heat stress. Wearing PPE that covers the body or face can reduce air movement and the cooling effects of sweating, resulting in a greater heat load on the body. Inappropriate work clothing, such as dark-colored or tight-fitting clothing, can also increase the risk of heat illness.

Heat stroke can occur in two forms: classic and exertional

Heat stroke is a heat illness characterised by a rapid rise in core body temperature above 40°C and central nervous system dysfunction. It can occur in two forms: classic and exertional.

Classic heat stroke occurs as a result of passive exposure to extreme environmental heat. It is often seen in epidemic form and contributes to 9-37% of heat-related fatalities during heatwaves. It is more likely to affect older individuals and those with pre-existing medical conditions.

Exertional heat stroke, on the other hand, develops during strenuous exercise or physical exertion. It can occur even in the absence of extreme environmental heat, such as when working hard in cold weather while wearing protective clothing that does not allow the body to dissipate heat effectively. Sweating, which is usually absent in classic heat stroke, is often present in the exertional form. Exertional heat stroke predominantly affects young and otherwise healthy individuals.

Regardless of the form, heat stroke is a medical emergency and can be fatal or lead to permanent disability. It is important to cool the affected individual as quickly as possible, for example, with a cold water or ice bath.

Construction workers are at an elevated risk of heat stress due to the strenuous nature of the work

Construction workers are at an elevated risk of heat stress due to the strenuous nature of their work. The physical demands of construction work can cause the body to generate excessive heat. Construction workers often work outdoors during the hottest times of the year, and sometimes in direct sunlight. They may also be exposed to heat sources that are part of the work process, such as welding and cutting torches or hot asphalt. All of these factors can place construction workers at an increased risk of heat-related illnesses and injuries (HRI).

Heat stress is a combination of a worker's exposure to heat from physical activity, environmental factors, and their clothing, resulting in an increase in the body's heat storage. Heat strain is the physiological response to heat stress, where the body tries to increase heat loss to maintain a stable body temperature. Core body temperature must be maintained within 1°C (1.8°F) of normal (about 37°C or 98.6°F) to continue functioning normally. However, the strenuous nature of construction work can cause the body to generate excessive heat, leading to heat stress and heat strain.

Construction workers are particularly vulnerable to heat stress because a majority of them engage in heavy work outdoors. They are exposed to extremely high temperatures with long working hours and may have limited or no access to shade or water. As a result, construction workers are more likely to experience heat-related illnesses and injuries. In the United States, construction workers are 13 times more likely to die from a heat-related illness compared to workers in other industries.

The risk of heat-related illnesses is further increased by the lack of regulations to protect construction workers. In many countries, there are no enforceable policies to prevent HRIs in the construction industry. Even in countries with guidelines, such as the United States, enforcement may be lacking. This puts construction workers at an elevated risk of heat stress and its associated health consequences.

To protect construction workers from heat stress, employers should implement preventive measures such as providing rest, shade, and water; training; acclimatization; developing a monitoring system for HRI signs; and limiting physical tasks. Additionally, work practices and personal protective equipment (PPE) should be adjusted to reduce heat exposure. For example, employers can schedule hot jobs for cooler parts of the day or alternate days and provide cool shaded or air-conditioned areas for rest and recovery. It is also important to encourage workers to wear light-colored, loose-fitting, breathable clothing.

By implementing these measures, construction workers can be protected from the elevated risk of heat stress due to the strenuous nature of their work.

Heat-related illnesses include heat stroke, heat exhaustion, fainting, heat cramps, and heat rash

Heat-related illnesses (HRIs) are preventable and range from mild to severe. They occur when the body is unable to regulate its temperature and include heat stroke, heat exhaustion, fainting, heat cramps, and heat rash. Heat stroke is the most severe form of heat illness and requires immediate medical attention. It occurs when the body's heat-regulating system is overwhelmed by excessive heat, resulting in a life-threatening emergency.

Heat exhaustion is more severe than heat cramps and results from a loss of water and salt in the body. It occurs in conditions of extreme heat and excessive sweating without adequate fluid and salt replacement. If left untreated, heat exhaustion can progress to heat stroke.

Heat cramps are the mildest form of heat illness and consist of painful muscle cramps and spasms that occur during or after intense exercise and sweating in high heat.

Heat rash, also called prickly heat or miliaria, is a stinging skin irritation that turns the skin red. It happens when excessive sweat gets trapped under the skin, blocking the sweat glands.

Construction workers are at an increased risk of HRIs due to the strenuous nature of their work and exposure to hot environments or extreme heat. They often work outdoors during the hottest times of the year and in non-climate-controlled spaces, such as attics, crawl spaces, or in direct sunlight on roofs. Additionally, certain factors can increase the risk of HRIs for construction workers, such as underlying health conditions, age, lack of acclimatization to heat, and restricted fluid intake.

To protect construction workers from the adverse health effects of working in the heat, employers should consider implementing engineering and work practice controls, training and acclimatization, measuring and assessing heat stress, and providing medical monitoring and heat-protective clothing and personal protective equipment (PPE).

Heat-related deaths among construction workers have seen an upward trend that corresponds with an increase in average summer temperatures

Heat-related deaths among construction workers have been on an upward trend, corresponding with an increase in average summer temperatures. Between 1992 and 2016, 285 construction workers in the U.S. died from heat-related causes, accounting for over a third of all occupational heat-related deaths in the country. This number may be an undercount due to misclassification.

The increase in heat-related deaths among construction workers is likely due to a combination of factors, including the strenuous nature of construction work, exposure to high temperatures, and a changing climate. Construction workers often work outdoors during the hottest times of the year and may be exposed to extreme heat for extended periods. The physical demands of construction work, combined with hot and humid conditions, can lead to excessive heat within the body, increasing the risk of heat-related illnesses and injuries.

The aging of the construction workforce and the increase in global temperatures are also contributing factors to the upward trend in heat-related deaths. As the body's ability to regulate temperature decreases with age, older construction workers may be more susceptible to heat-related illnesses. Additionally, 19 of the 20 warmest years on record have occurred since 2001, according to NASA, indicating a clear trend of increasing temperatures.

To protect construction workers from heat-related illnesses and deaths, employers should implement measures such as providing rest, shade, and adequate hydration. Acclimatization to the heat is also crucial, as most heat-related fatalities occur during the first few days on the job. Educating workers about the signs and symptoms of heat-related illnesses and encouraging them to speak up when they are feeling unwell can also help prevent fatalities.

Furthermore, regulations and policies should be enforced to protect construction workers from heat exposure. While the Occupational Safety and Health Administration (OSHA) in the U.S. has guidelines for employers to protect workers from heat, there is currently no heat stress standard in place. The implementation of enforceable policies and regulations could help reduce the number of heat-related deaths among construction workers.

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