By Nicole Moyen, Vice President of Research and Development at Kenzen and heat stress blogger
When it comes to planning for the prevention of heat-related injuries & illnesses among an entire workforce, a one-size plan does not fit all.
The research behind managing worker safety under hot working conditions has largely been based on studies of young, healthy men, which means that other populations – women, older adults, and people with other risk factors – will need different accommodations if a heat safety program is to be effective.
Sex, age, health status, and other factors can impact risk
According to researchers who study how heat affects workforces, “…existing guidelines adopted and recommended for use by government agencies worldwide to protect the public and workers also assumes a “one size fits all” approach to protect human health. These guidelines generally prescribe protective measures (e.g., heat advisories, exposure limits) using models defined by the assessment of heat strain in young and/or relatively healthy adults. They fail to consider key factors such as sex, age, health status, and other factors, which can markedly alter a person’s tolerance to heat, thereby leaving a large segment of the population under-protected…” (1)
For example, a man working at the same relative work rate as a woman will typically have a higher sweat rate. This is because men generally have a larger body-surface-area-to-mass ratio than women.
Given that sweating is the main way a body gets rid of body heat, this higher sweat rate among men means that their body temperature will be lower in hot-dry (low humidity) climates. As a result of this higher sweat rate & lower body temperature, men will likely be able to work for a longer period of time than women. However, in hot-humid climates where sweat can’t evaporate as easily and therefore doesn’t cool you down, women will likely be able to work for a longer period of time than men. This is because men will continue to sweat more than women, but this sweat won’t be cooling them down, and in fact, they’ll just lose a lot of body water. The effect: in hot-humid environments, men will become dehydrated more quickly than women, and see a faster increase in core body temperature – the primary trigger of heat-related injuries and illnesses.
Older workers more susceptible to heat stress
Another natural factor that can vary the susceptibility of heat-related injuries and illnesses among workers is age. After age 35, the body’s ability to dissipate heat, primarily through sweating, declines. As a result, older adults tend to have higher core body temperatures than younger adults, when working at the same rate in the heat. This difference between older and younger individuals can be minimized with heat acclimatization and endurance training.
In addition, some people are able to acclimatize faster and tolerate heat better than others; a portion of this appears to be attributable to genetic makeup.
Moreover, there are various diseases that can impair the body’s ability to effectively thermoregulate, such as various cardiovascular diseases (e.g., hypertension), sweat gland disorders (e.g., Type I and Type II diabetes), skin disorders (e.g., psoriasis), and metabolic disorders. Individuals with these diseases will be at increased risk for heat-related injuries and illnesses.
These factors (age, biological sex, and disease) affect each individual differently when working in the heat, and therefore require workforce supervisors to alter their approach in developing work/rest schedules for workers. It is important to observe changes in employees’ health while on the job site and take appropriate, individualized measures to ensure that each person remains at safe core body temperatures. Always listen to workers when they say they’re not feeling well, and allow them to take a break.
Smart PPE sensors can detect and relay warnings
Smart personal protective equipment (PPE) is available to monitor individual workers’ health during work in the heat. New sensors, worn on the body, can detect and relay warnings to both the worker and supervisor and alert when an intervention – such as stopping work, resting, and allowing the body to cool-down – should happen.
In the absence of such a system, active monitoring such as keen observation, a worker-buddy system that pairs employees with each other to do “check-ins,” and encouraging workers to be acutely aware of their body’s signals of heat injury/illness are all ways to help prevent the negative consequences of heat stress on workers.
When an employee begins to exhibit goosebumps or chills, light-headedness, nausea, and/or feels more weak or fatigued than usual, likely they are experiencing heat exhaustion. Other indicators include fainting, light-headedness, unusually hot skin, excessive sweating, potential vomiting, and difficulty working.
If the worker experiences hallucinations, behavior changes such as aggressiveness, irritability, confusion, and/or irrational tendencies, feels week, or is no longer able to work, their core body temperature may have reached greater than 104°F or 40°C. Likely, this person is experiencing exertional heatstroke. This is a medical emergency and the person needs to be immediately cooled in an ice-water bath.
Flexible work-rest schedules can make a difference
Again, given the person’s biological sex, age, genetics, and diseases, people on your workforce will react differently to working in hot and humid conditions. The main way to “customize” a heat safety program for a diverse team is to be flexible in work-rest schedules. Not all workers will need a break at pre-designated intervals. The body signals outlined above will dictate when rest is needed, where cooling (finding shade and/or air conditioning, and removing excess clothing) and hydration should be emphasized.
During the rest periods, continue to observe individual workers and check their ability to return to work every 10-15 minutes. Because each person will respond completely differently to working in the heat, only that individual can indicate when they’re ready to safely return to work.
Kenny, G.P., Notley, S.R., Flouris, A.D. and Grundstein, A., 2020. Climate Change and Heat Exposure: Impact on Health in Occupational and General Populations. In Exertional Heat Illness (pp. 225-261). Springer, Cham. https://www.osha.gov/heat/
Budd, G.M., 2008. Wet-bulb globe temperature (WBGT)—its history and its limitations. Journal of Science and Medicine in Sport, 11(1), pp.20-32.
Regulation, T.R.A.D.O.C., 2016. 350-29. Prevention of heat and cold casualties. Fort Eustis, VA: US Army Training and Doctrine Command, Publication TRADOC Regulation, pp.350-29.
Coco, A., Jacklitsch, B., Williams, J., Kim, J.H., Musolin, K. and Turner, N., 2016. Criteria for a recommended standard: occupational exposure to heat and hot environments. control Ccfd, editor.
Nicole Moyen leads R&D at Kenzen, the smart PPE innovator focused on physiological monitoring and the prevention of heat injury and death among workers. Kenzen’s real-time heat monitoring system is used by companies to keep workers safe from heat. Moyen has a decade of research experience in industry and academia related to human physiology and wearable devices and advises companies on heat stress physiology and dehydration. Nicole has an M.S. in Exercise Physiology and is currently finishing her PhD in Biology from Stanford University.
In our last issue we discussed the ways the body works to process heat, the types of illnesses that can result from overheating, and the best ways to gauge outdoor heat conditions in our recent article, “Mitigating the Hazards of Working in the Heat,” but today, we are going to take a deeper dive into what it takes to stay safe in the heat. As any mason knows, the heat is definitely the enemy every summer, and often into fall, especially in the Southern states.
Masonry can require a lot of bending, lifting heavy objects, and working in direct sunlight when the shade is unavailable, all of which is hard work that produces a lot of heat. Despite educational efforts and resources dedicated to preventing heat-related illnesses on jobsites, thousands of masons fall victim to heat stress, exhaustion, or stroke every year, and some cases are fatal.
What If There Was No Money?
According to the OSHA website, a majority (50%-70%) of outdoor heat-related fatalities occur within the first few days of working in warm or hot environments because the body needs to acclimate or build a tolerance to the heat gradually over time. Otherwise, a high heat index is a major risk factor for heat exhaustion or worse in non-acclimated individuals. Heat-related illnesses can creep up on a worker quickly and without warning, and are an ever-present threat in outdoor or even certain indoor conditions in the year’s warmest months, but there are several strategies and options that work particularly well for masons when it comes to beating the heat.
Old School Methods
Some of the most effective methods for masons to protect themselves from heat stress on the jobsite are also the simplest, just ask Zach Everett. An experienced Corporate Safety Director at Brazos Masonry, Everett has years of experience dealing with supervising and keeping workers safe from a variety of hazards on the jobsite, and especially from the heat. One of the first things to keep in mind is that removing clothing when temperatures climb may not be a temperature lower measure even though you may feel a little more comfortable.
“Some people like to take off a lot of clothes in the heat, that might be a misconception and can actually make things worse because you have direct sunlight on your skin,” he cautions, “if you start actually getting sunburned that will actually start raising your body temperature as well.” To protect yourself, he recommends wearing light-colored cotton clothing to wick away sweat and to help cool you off a bit. Cooling towels, which can be soaked in cold water for longer-lasting relief, are also a recommended option.
While workwear is the first thought, there are other more out-of-the-box methods for working around, rather than against the heat. As any mason contractor will tell you, productivity drops a little bit during the hotter months. The increased heat requires heightened precautions like more frequent breaks in the shade and better access to water, but these measures can be extended even further. For example, Everett takes the extra step of encouraging his crew to take a slower and easier pace during safety meetings to avoid overexertion and heat exhaustion. While this action could potentially lead to some delays in the overall completion of the project, it might also save lives.
However, for projects on a tight schedule, Everett has a more creative suggestion: working at night. A night shift can make things 10-15 degrees cooler for workers, which is a bonus but comes with the obvious drawback of poor visibility. To combat this, “you have a lot of light towers hitting your work from a lot of different angles so you don’t have a lot of shadows,” which has the added benefit of keeping workers safe in the dark as well.
A final suggestion for mason contractors is to work with the surrounding environment to protect workers. By starting on the west side of the building when the sun is rising in the east, and then moving to the east side of the building during the afternoon when the sun is setting in the west. By doing this, workers remain on the shady side of the building throughout the day, though this is only possible when in permissible locations. Another situationally based solution is to introduce sun shades when working on scaffolding which blocks the sunshine from masons’ backs and further reduces heat and sun exposure.
New School Methods
While the above are simple solutions that can easily and simply be implemented, they all lack one crucial element to keeping workers safe: monitoring. While self-monitoring and the awareness of your peer’s physical condition are important, they are not foolproof methods for keeping masons safe in high heat index conditions. When working in the outdoors, keeping watch for excessive sweating or facial redness, a sudden lack of sweat, headaches, nausea, or dizziness should always be a priority.
It is easy to get consumed in the job in front of you, and not realize there is a problem until heat stress has already set in. However, the recently released Kenzen Patch can keep an eye on working conditions that are now and is accessible for mason contractors everywhere.
As masonry technology moves into the 21st century with the development and introduction of equipment like exoskeletons and AR/VR training, it only makes sense that smart PPE is not far behind. By using smart technology like sensors integrated with cloud connectivity to deliver real-time safety information to both the wearer and jobsite safety supervisor simultaneously. Technology like the Kenzen Patch is able “to keep industrial workforces safe from heat, fatigue, and overexertion on the job through the delivery of real-time alerts,” stated Heidi Lehmann, Chief Commercial Officer at Kenzen. According to the Kenzen website, the Patch is a small, flexible device that helps you better understand your physiology. Worn during the work shift, receive personalized health insights and notifications to help you stay safe in the most strenuous scenarios.
The Patch is appropriately named as that is exactly what it is. When placed either on the arm or on the chest, the Patch was designed to be comfortable and worn the entire day. It feeds real-time health information directly to the wearer, the jobsite safety supervisor, and EHS corporate by sampling data like temperature and heart rate every five seconds, resulting in a whopping 1.3 million data points per worker per day. This information is used to keep track of current physical activity levels and allows workers to monitor their own heat responses instantly. This is especially useful as “physiologically” we are all different.
Additionally, the Patch is said to take each individual into consideration so it is personalized for them. “Even if everybody is in the same situation and doing the same type of work, one individual might overheat or be up towards heat injury where everyone else might not be,” explains Lehmann. The individualized data processing is said to allow the Patch to be intuitive and instantly alerts users when they are approaching heat exhaustion.
Some have concerns about the sharing of their personal health information, and this is often one of the first issues raised when users begin adopting the Patch system. This concern was not treated lightly by Kenzen, who designed the entire system with user privacy in mind. Lehmann states, “the worker is the only one that sees all of their health data in real-time, and retrospectively, the safety manager is only going to see if a worker is up for heat injury, has dismissed alerts and needs an intervention, so all they see is in the moment ‘do I need to intercede to keep this worker safe.’”
There is also a separate feed that goes to corporate management, but that information is completely used for risk analysis and management. With the ability to visualize sweeping data trends across jobsites, corporations can then make recommendations to shift work times or put additional heat safety protocols into place, like lighter PPE or additional equipment. With so much information available on both the individual and managerial levels, it is no surprise that smart PPE is quickly becoming the way of the future for masons working in high heat index conditions.
Whether you have embraced old school heat safety techniques or are interested in adopting more advanced technology to keep yourself and others safe on the jobsite, the fact remains that every year work conditions seem to be growing hotter and the heat must be addressed. From clothing, to shift times, to new smart PPE like the Patch, more and more options are available for masons to protect themselves from dangerous outdoor working conditions.
Ultimately, it is up to every individual on the jobsite to practice proper heat safety precautions, and the key to preventing heat stress injury starts with education. If you’re interested in how you can keep yourself and your employees safe in hot temperatures, be sure to stay updated on the best ways to do so at masonrymagazine.com.
Every safety product must meet minimum standards, set by OSHA, and may meet optional standards set by ANSI. Standards should be the starting line, not the final goal, when building safety products for today’s workers. Since the purpose of safety products is to save lives, it always makes sense that innovation teams at product design and manufacturing companies continue to push the boundaries of what a product can do more of and/or better.
More lives saved is the incentive that fuels the drive of product innovators in fall protection. Is there a component that can be made from a different material to make the product stronger, i.e. able to hold more weight in more extreme environments or scenarios? Is there a reconfiguration that will make the product more comfortable for the user, so that it is more likely to be used and appreciated?
When design teams push the envelope to bring products to the next level, standards are updated, fewer injuries occur and, ultimately, more workers return home safely from their jobs.
As if 2020 couldn’t get any more stressful, experts predict it will be the hottest year on record for atmospheric temperatures. The heat comes at a time when managing productivity and safety to maximize revenue for struggling industries is paramount. Heat is an added factor that must be considered as businesses navigate how to effectively recover after COVID. Employers must take proper precautions to mitigate their heat risk as they move forward with projects this summer.
Watch for signs
First, it’s important that outdoor workers who have been quarantined to stop the spread of COVID, or because they were ill or furloughed, to be screened before returning to work, as body temperature is a key indicator of the virus. After they start work, however, it is equally important to watch for signs and symptoms of other temperature-related setbacks – specifically injuries and illnesses caused by hot weather.
With shelter-in-place orders across much of the globe, many workers were likely spending their time away from work in temperature-controlled homes instead of working outside, as they typically would during the day. This is problematic because research shows that those accustomed to air-conditioning are less tolerant of the heat when they venture out into it.
This is a recipe for disaster that will likely lead to an increase in the number of heat-related deaths, injuries, and illnesses in 2020. This may bring these safety statistics to record levels – significantly adding to the numbers of 783 workers killed and 69,374 critically injured by heat on the job. The added impact from rising air temps and workers coming off COVID quarantine will likely boost heat stress incidents that were already on the rise, as the number of worker days spent in dangerous heat conditions is estimated to almost triple by 2050 for construction workers alone.
According to the CDC, the onset of heatstroke can increase a worker’s body temperature to 106 degrees Fahrenheit within just 10-15 minutes. In fact, the U.S. military recently identified heat exposure as a significant, growing threat – with an increase of almost 60 percent in exertional heat stroke and heat exhaustion cases since 2008. High heat can also increase the risk of occupational injuries by as much as nine percent, as shown by a recent ISGlobal study published in Environmental Health Perspectives. The personal impacts of heat include increased mental demand, and reduced dexterity and endurance on the job. Long-term impacts of consistently working in the heat can include chronic kidney disease and organ damage.
Seventeen of the 18 hottest years on record have taken place since 2001, and an average of 2.2 million workers (in the ag and construction industries alone) work in extreme heat during summer’s peak. The National Weather Service reports that heat was by far the leading cause of weather fatalities over the past 30 years. Heat stress affects all workers. Workers may appear healthy and, once heat injuries are detected by the naked eye, it’s actually too late. Since most workers don’t want to raise any flags about their own health, they often wait too long to take a break – and at that point, typical on-site treatments such as rehydrating and escaping the sun aren’t enough. Often, by the time a worker takes him or herself out of the heat, the damage is done.
In addition to worker health and safety, heat causes company impacts such as higher insurance costs, lost productivity, and reputational and legal risks if workers are not accommodated to protect their health and wellness. Employers in the U.S. spend $220 billion annually on injury and illness related to excessive heat. Only three states – California, Minnesota, and Washington – currently have OSHA heat standards in place, and these aren’t even the hottest states in the U.S. With the majority of states lacking OSHA heat stress standards, workers are laboring in sub-optimal conditions, with little protection or training. This exposure results in more injuries and hospitalizations, fewer worker days, and increased Worker Compensation costs.
In fact, research shows that, for every 10 degrees Fahrenheit increase in outdoor temperature, there is a 393% increase in hospitalizations for heat exposure, and one study calculated the healthcare costs of a single California heat event at $179 million. Moreover, these impacts are fully preventable, since the risk of injuries and illnesses can be easily monitored by measuring each individual’s physiological responses to the heat.
To combat the risk, and associated costs, companies now spend $67 billion annually in smart PPE and protective equipment. The latest heat safety products include technology that provides continuous, private monitoring of individual workers’ physiological responses. Before this type of smart PPE, companies simply looked at accidents after the fact, with little ability to predict elevated risk for individual workers.
Now, new technology enables safety managers to both predict and prevent near-misses. Devices are often smaller than a cell phone and easy to wear, with no discomfort to the user. Users can review an individual’s leading biometric data such as heart rate, core body temperature, and sweat loss. And dashboards for each worksite team keeps management informed, while maintaining individual worker privacy.
Unlike temperature guns (now used to admit workers back on the site after scanning for virus-related body temperatures) which create an immediate lack of privacy, continuous individualized monitoring through smart PPE is covert. If an indicator warrants intervention, management can simply speak with the worker, without alerting others to the concern. Rather than reviewing heat-related injuries and illnesses after the fact, continuous monitoring allows users to predict and prevent heat incidents – keeping workers safer and fit for duty, while increasing output and lowering health care expenses.
In the not-so-distant future, heat monitoring through smart PPE may eliminate the need for temperature guns, as a worker may be able to use a wearable device prior to clocking in, so that body heat caused by both viruses and air temperatures can be detected and distinguished before the work even begins. This would allow workers who might be coming down with an illness to stay home from work and avoid spreading the disease to the rest of the workforce.
Heat-related risks, and thus the costs, for both workers and their employers, keep mounting. That’s the bad news. The good news is, through heat prevention methods like acclimatization and heat interventions such as breaks, hydration, shade/air-conditioning, and ice baths, risks can be addressed and proactively managed. And, as innovation continues in the smart PPE industry, individualized monitoring can be even more effective in reducing heat-related injuries and illnesses by providing real-time alerts when workers are unsafe and need to take a break.
For the growing problem of heat injuries and deaths, there are growing solutions. The key is to stay vigilant in understanding the conditions under which workers are being asked to perform, and being proactive in managing their risk, and therefore yours.
Beyond the standard PPE of vests, glasses, and hard hats, wearable technology can further improve safety for construction workers. Here are six construction safety wearables for 2020 that address the dangers of heat exhaustion, fatigue, and lack of visibility, among other job site hazards.
Kenzen’s body heat sensor system
Kenzen’s body heat sensor system
Kenzen’s real-time worker heat monitoring system includes a wearable device worn by workers on their arm which alerts both the worker and their supervisor when core body temperature is too high. Real-time alerts allow for immediate intervention and worker safety from heat injuries.
Kenzen’s multi-level alerts are sent to workers via device vibration, iOS or Android app notification, and to supervisors via web dashboard alert signaling that the worker should take a break and allow their temperature to return to safe levels. Alerts are accompanied by actionable recommendations such as advising the worker to take a break, find shade, drink water, or remove any excess clothing and equipment to decrease body heat. A second “back to work” alert then indicates when the worker’s core body temperature has returned to a safe level.
Smart PPE developer Kenzen has launched a wearable real-time worker heat monitoring system.
The cloud-based Software as a Service (SaaS) system includes a wearable device worn by workers on their arm, which alerts both the worker and their supervisor when core body temperature is too high.
Real-time alerts allow for immediate intervention and worker safety from heat injuries.
The wearable tech, via its advanced sensor, monitors multiple physiological and environmental metrics, including heart rate, activity, skin, and ambient temperatures. The sensor data allows for the real-time prediction of core body temperature, providing alerts to workers and supervisors when temperatures approach unsafe levels.
“The Kenzen system is all about prediction and prevention. Heat-related injuries are 100 percent preventable, but potentially deadly and difficult to detect until it’s too late,” said Heidi Lehmann, Kenzen’s chief commercialization officer.
Kenzen’s multi-level alerts are sent to workers via device vibration, iOS or Android app notification and to supervisors via web dashboard alert signaling the worker should take a break and to allow their temperature to return to safe levels.
Alerts are accompanied by actionable recommendations such as advising the worker to take a break, find shade, drink water, or remove any excess clothing and equipment to decrease body heat.
When the worker’s core body temperature has returned to a safe level, a second “back to work” alert notifies the employee.
Data captured by the system can be used to help companies identify heat risk and manage outcomes by adapting worksites accordingly to improve worker safety while maximizing productivity.
Modifications may include changes to work-rest schedules, where and when to add water and shade stations, the addition of air-conditioned rest areas, and even recommendations for pre-staging ice-bath locations in case of extreme weather and working conditions.
The data can also inform decisions around workplace expenditures such as certain equipment and clothing.
The Kenzen system has been tested on worksites of large industrial conglomerates across the globe in domains such as construction, field services, power, oil, and gas as well as renewable energy.
A new system from health monitoring firm Kenzen can help employees keep cool this summer when working outside. The company claims the Kenzen Patch, a black arm band that goes around the bicep and has a related mobile app, continuously monitors a worker’s body temperature to help avoid heat-related illnesses.
The patch, according to Kenzen Chief Commercial Officer Heidi Lehmann, allows safety supervisors to see real-time metrics, allowing them to respond to a potential health threat before a worker becomes ill.
Companies also can view anonymized data sets to identify changes that would help mitigate future issues caused by heat, such as increasing break times or more water stations. The patch is in limited release, but contractors can test the product now because it is available for sale in the fall.
During the hot summer months, construction workers are among those at the highest risk of heat exhaustion, according to OSHA, especially when working outdoors on roofing or roadway projects.
Using the patch system, workers can track and follow their own biometric data, including body temperature and heart rate, while safety supervisors see real-time data and alerts, Kenzen said.
Although not designed to specifically monitor a possible coronavirus-related infection, Lehmann said the sensor indicates when a worker’s body temperature is elevated. A safety manager can then use context to decide if the raised body temperature resulted from fever or from heat-related conditions.
Kenzen found construction workers would not necessarily heed their own warning signs if viewing data on their personal phones, whereas if a supervisor informed them their body temperature had risen they would be more likely to take a break, Lehmann said. In addition, if workers are put in charge of monitoring their own vitals through the app, they may not have their cell phones with them.
“A lot of times on construction sites the workers can carry phones in certain areas,” she said. “But in certain environments either it was disruptive to the workflow or they weren’t allowed to carry them.” This informed the decision to put the live information into supervisors’ hands.
In related news, Boston-based Shawmut Design and Construction recently implemented Feevr, a device that uses artificial intelligence to detect elevated temperatures in groups of people to determine if any workers might have a fever without having to come into physical contact with the individual.