Managing Workers' Comp: Taking the Stress Out of Heat

Even though resources are plentiful and the cost of prevention is minimal, every year, thousands of workers become sick from exposure to heat and some die.

Heat-related exposure includes not only heat cramps, heat exhaustion, fainting and heat stroke, but also injuries from falls, equipment operation and accidents that occur when a worker has sweaty palms or fogged safety glasses or becomes dizzy, disoriented or fatigued as a result of dehydration.

Studies show that dehydration levels of 2 percent of body weight or more impair visual motor tracking, short-term memory, attention and arithmetic efficiency. A 23 percent reduction in reaction time occurs at the 4 percent dehydration level. Such declines in cognitive performance significantly can increase the risk of work-related accidents.

The problem is not limited to those who work outside. Those who work around machinery and in confined spaces – such as mechanics, steamfitters, ship builders, plumbers, bakery workers, boiler room workers and drycleaners – can be at risk for heat stress.

Training employees about the warning signs of heat stress and how it can be prevented is key, and there are many valuable resources available through OSHA, the Centers for Disease Control and Prevention and NIOSH. But employers need to understand the physical, emotional and psychological reasons it occurs for the training to be effective. Here are some key points:

One size does not fit all. According to NIOSH, while workers can acclimatize themselves to different levels of heat, each worker has an upper limit for heat stress beyond which that worker can become a heat casualty. This varies by body size, state of wellness, lifestyle, etc.

Heart disease, high blood pressure, pregnancy, age (over 65), diabetes and alcohol consumption may increase the risk of heat stress. In addition, certain medications, including anti-psychotics and anti-cholinergics, are known to increase the risk of heat stroke because they inhibit the body’s ability to regulate its temperature.

Employees need to recognize the importance of monitoring off-the-job behavior.

Some symptoms of heat exhaustion, such as irritability, thirst, headache and heavy sweating, can be rationalized as “normal” in hot environments. There is a natural tendency to minimize the significance of these early warning signs.

It is estimated that 80 percent of the population begins the day slightly dehydrated. It is a common misconception that taking fluids to hydrate the body is enough to prevent heat stress. However, in certain circumstances, it can take as much as 24-hours for the body to absorb enough fluid to fully rehydrate.

The effects of heat-related illnesses also can result in long-term disabilities. In an unpublished decision, Steele v. Surry County, No. COA10-607 (N.C. Ct. App. 04/05/11, unpublished), the North Carolina Court of Appeals held that a heavy equipment operator was entitled to temporary total disability benefits. The operator, who suffered a seizure while working at the bottom of a landfill pit, continued to have seizures after being released from the hospital. The North Carolina Court of Appeals held that the operator showed his seizures were causally related to the heat-related illness, and he was entitled to temporary total disability benefits.

Employers who educate workers about the medical and behavioral risk factors as well as the symptoms of heat-related illness, and instill the importance of working safely by proper scheduling, providing adequate breaks, providing plenty of cool water, gradual indoctrination to adverse work conditions and preparing an emergency plan should heat-related illness occur, will be most successful in preventing illness and injuries.


Kevin Ring is the lead workers’ compensation analyst for the Institute of WorkComp Professionals, which trains insurance agents to help employers reduce workers’ compensation expenses. He is a licensed property and casualty insurance agent. He can be contacted at 828-274-0959 or [email protected].

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