Middle East

Heat Stress Prevention

1.0 Purpose and Scope

1.1 Field supervisors are responsible for protecting their workers from heat stress conditions by
incorporating protective measures into the work routine. The heat stress prevention procedures below
will be implemented whenever the temperature exceeds 81 degrees F/27 degrees C for workers in
normal work clothing, or 65 degrees F/18 degrees C for workers in chemically protective clothing.

1.2 This procedure applies to all AECOM projects and operations where personnel work in environments
that may cause heat stress.

2.0 Terms and Definitions

2.1 Heat Stress - A common hazard to employees working on projects involving exposure to
hazardous substances, most particularly when impermeable protective
clothing is used. This problem can occur at ambient temperatures below what
is normally considered “hot weather”. The body normally sheds excess heat
primarily through radiation (capillaries in the skin dilate, transferring heat from
the body core to the surface), and evaporation of sweat. Heat stress results
when the body’s regulating mechanisms are inadequate to dispose of
internally generated and externally supplied heat.
- Outdoor activities and operation conducted in hot weather, especially those
that require workers to wear semi-permeable or impermeable protective
clothing are likely to cause thermal stress among exposed workers.
Consequently, prevention of thermal stress is an important consideration,
particularly during the summer months when temperatures may reach above
45°C and humidity reaching 90%.
- Refer to table given in Attachment 1 for level of risk associated with varying
temperature and humidity, it will be evident from this table that for the majority
of the time, the ambient temperature/humidity prevailing in hot countries
places the worker in the category of Extreme caution, Danger or Extreme
danger. This risk must be carefully and diligently managed.

3.0 References

3.1 AD EHS RI - CoP - 11.0 - Safety in the Heat

3.2 Qatar Construction standards

3.3 Local Labor Laws

4.0 Procedure

4.1 It is important that all employees are adequately trained to enable them to understand and recognize the
various types and causes of thermal stress related illnesses/injuries. This will assist employees in
preventing the occurrence of such illnesses/injuries and will enable them to provide immediate treatment
to persons displaying the symptoms of thermal stress.

4.2 No person will be allowed to work alone in heat stress areas.

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 4.3 Types of Thermal Stress Illnesses/Injuries
4.3.1 Heat Stroke
Heat stroke is a condition caused by prolonged exposure to high temperatures, in which
people experience high fever, headaches, hot dry skin and physical exhaustion. In extreme
cases, a sufferer may physically collapse and go into a coma. When a person is assessed
to have suffered from heat stroke, emergency medical treatment must be immediately
sought.
Symptoms

1. Extremely high body temperature

2. Red, hot and dry skin (no sweating)
3. Rapid and strong pulse
4. Throbbing headache
5. Dizziness
6. Nausea
7. Confusion
8. Unconsciousness
Treatment

1. Immediately call for emergency medical assistance.

2. Move the person to a cool and shady area. Do not leave the person alone.
3. Cool the person rapidly with running water, cold compresses and/or rapid fanning.
4. Provide cool water if they are alert. Avoid caffeine and alcohol.
5. If the person is unconscious, do not give them water.
6. Continue to cool their body temperature until medical assistance arrives and they can
be taken to a medical facility for further cooling and monitoring of body temperature
and functions.
4.3.2 Heat Exhaustion
Heat exhaustion is a condition caused by excessive fluid loss due to sweating, resulting in
the depletion of body fluid volume, which creates an imbalance of the electrolytes in the
body.
Symptoms

1. Heavy sweating
2. Paleness of skin. Skin may be cool and moist
3. Muscle cramps
4. Tiredness
5. Weakness. Pulse rate may be fast but weak. Breathing may be fast but shallow
6. Dizziness
7. Headache
8. Nausea or vomiting
9. Fainting
Treatment

1. Immediately call for emergency medical assistance.

2. Move the worker suffering from heat exhaustion to a cool and shady area. Do not
leave the person alone.

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 3. Cool the person rapidly with running water, cold compresses and/or rapid fanning, if
possible.
4. Provide cool drinking water, or electrolyte/ion replacement drinks, if they are alert.
Avoid caffeine and alcohol.
5. Remove extra clothing when necessary and continue to cool their body temperature
until medical assistance arrives.
4.3.3 Heat Cramps
Heat cramps are painful spasms of the muscles generally thought to be caused by an
imbalance of electrolytes (e.g. essential minerals, such as sodium, potassium, calcium and
magnesium) in the body. This may occur when a person carries out strenuous physical
activity, drinks large quantities of water, but fails to replace salts/electrolytes lost through
sweating.
Cramps can occur during or after working hours and may be relieved by drinking saline/
electrolyte solutions. In more serious cases and if determined necessary by a doctor, a
saline solution should be administered intravenously for quicker relief.
Symptoms

1. Muscle pains or spasm usually in the abdomen, arms or legs.

Treatment

1. Immediately call for emergency medical assistance.

2. Stop all activity and sit quietly in a cool and shady area. Inform nearby workers of the
problems encountered.
3. Drink clear juice or a liquid containing salt (e.g. electrolyte/ion replacement drinks).
4. Do not return to strenuous activity for at least a few hours after the cramps subside. It
should be noted that further exertion might lead to heat exhaustion and/or heat stroke.
5. Seek medical attention if heat cramps do not subside within 1 hour.
4.3.4 Heat Rash
Heat rash, also known as prickly heat, may occur in hot and humid environments where
sweat is not easily removed from the surface of the skin by evaporation. When extensive,
or complicated by infection, heat rash can be so uncomfortable that it inhibits sleep and
impedes a worker's performance or even results in temporary total disability. In most
cases, heat rashes will disappear when the affected individual returns to a cooler
environment.
4.3.5 Ultraviolet (UV) Radiation
Broad-spectrum UV radiation is classified as a known human carcinogen.  UV radiation can
cause harmful effects from both chronic and acute exposures including reddening of the
skin, accelerated skin ageing and damage to the eyes (e.g. cataracts, retinal burns,
welder’s flash) and sunburn.  AECOM employees may be exposed to UV radiation from
natural sunlight or manmade sources such as germicidal lamps (e.g. UV groundwater
treatment systems) and welding. 
Special consideration shall be given to work activities at higher elevations as the intensity of
UV exposures are significantly higher than at lower elevations.  Typically, UV exposure can
increase 4-5% for every 1000 feet/300 meters ascended.  Some medications can adversely
react to significant UV exposure resulting in severe sunburn.

4.4 Causes of Thermal Stress Illnesses/Injuries

4.4.1 Individual Susceptibility

1. It is difficult to predict just who will be affected by thermal stress and when, because
individual susceptibility varies. In addition, environmental factors causing thermal
stress are not restricted to ambient air temperature, as radiant heat, air movement,
conduction and relative humidity all affect an individual's response to heat.

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 2. Age, weight, degree of physical fitness, degree of acclimatization, metabolism, use of
alcohol or drugs and a variety of medical conditions, such as hypertension, also affect
a person's sensitivity to heat. Even the type of clothing worn must be considered. All
AECOM and Subcontractor employees will undergo a pre-employment health
assessment, performed by a health practitioner to ensure that they are physically fit
and do not have a serious pre-existing medical condition prior to being assigned to
the Project.
4.4.2 Temperature

1. The higher the air temperature, the less heat the body can lose by convection,
conduction and radiation. If the temperature of the environment increases above skin
temperature, the body will actually gain heat from the environment instead of losing
heat to it.
4.4.3 Air Humidity

1. The amount of moisture present in the air determines whether moisture (sweat) in
vapor form flows from the skin to the environment, or vice versa. In general, the
moisture concentration at the skin will be higher than in the environment, making
evaporative heat loss from the skin possible.
4.4.4 Wind Speed

1. Convective and evaporative heat losses increase with increasing wind speed.
4.4.5 Clothing Insulation

1. Clothing functions as a barrier to heat and moisture transfer between the skin and the
environment. In this way it can protect against extreme heat and cold but, at the
same time, it hampers the loss of excessive body heat generated during physical
activity / effort.
4.4.6 Engineering Controls

1. We will consider the implementation of either or all of the following engineering control
measures to minimize the potential to expose workers to conditions that may cause
thermal stress.
4.4.7 Convection Methods

1. General Ventilation - to dilute hot air with cooler air (generally cooler air that is brought
in from the outside). Such control measures will be considered for the workshops and
confined spaces.
4.4.8 Conduction & Radiation Methods

1. Insulation - Insulating hot surfaces that generate heat, to reduce the amount of heat to
which a worker may be exposed.
2. Shield - can be used to reduce radiant heat, i.e. heat coming from hot surfaces within
the worker's line of sight. Surfaces that exceed 35°C are sources of infrared radiation
that can add to the worker's heat load. Shields should be located so that they do not
interfere with airflow, unless they are also being used to reduce convective heating.
The reflective surface of the shield should be kept clean to maintain its effectiveness.
4.4.9 Refrigeration Methods

1. All buildings at site, particularly offices and accommodation/camp buildings, shall be

cooled using air-conditioning units.
4.4.10 Shade

1. Canopies or awnings shall be provided over sections of the site where work is being
carried out to shield workers from the UV rays of the sun, as well as from the direct
heat of the sun. Canopies, awnings or tents will also be erected to provide shade for
workers taking their predetermined rest breaks, to minimize their exposure to the
direct sun (refer to Section 4.4 below).

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 4.5 Limiting Exposure Time and/or Temperature (Work-Rest Regime)
4.5.1 The following measures will be implemented to minimize the exposure of workers to
conditions that may cause thermal stress:

1. When possible during the hot season, schedule strenuous or hot jobs for the cooler
part of the day (early morning, late afternoon, or night shift).
2. Add extra personnel to reduce exposure time for each member of the crew.
3. Permit freedom to interrupt work when a worker feels extreme heat discomfort.
4. Adjust schedule when possible so that hot operations are not performed at the same
time and place as other operations that require the presence of workers.
5. Provide regular rest breaks during hot weather to allow the body to cool down,
especially where the work is hard, physical. The following table provides guidance as
to the minimum rest breaks to be provided every hour for outside work during high
temperatures.
6. Provision of a thermometer to monitor ambient shade temperature.

Temperature (oC) * Rest Period (every hour)

40 to 45 7 minutes

45 to 48 10 minutes

48 to 50 15 minutes

50+ Stop work until the temperature reduces

* Provide air-conditioned sheds / buildings or vehicles for workers to take rest breaks
in and locate these rest areas as close as permissible to the work area.
4.5.2 The UV Index can help employees be aware of the level of UV radiation expected exposure
on a given day:

Exposure Index
Sun Protection Messages
Category Number

Wear sunglasses on bright days. In winter, reflections

Low <2 off snow can nearly double UV strength. If you burn
easily, cover up and use sunscreen.
Take precautions, such as covering up and using
Moderate 3-5
sunscreen.

High 6-7 Protection against sunburn is needed.

Take extra precautions. Unprotected skin will be

Very High 8-10
damaged and can burn quickly.
Take all precautions. Unprotected skin can burn in
Extreme 11+
minutes.

Source:  http://www.epa.gov/sunwise/stayheal.html

4.6 Fluid Replacement

4.6.1 Workers are advised to drink adequate amounts of water frequently (preferably every 20-
30 minutes) to replace the water lost through sweating.
4.6.2 Each worker is advised to drink at least 2 litres of water every 2-3 hours.

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 4.6.3 It is recommended that workers do not take salt tablets (or large amounts of salt on their
food), as more water will be required by the body to remove excess salt, which increases
the amount of work for the kidneys and further increases the risk of dehydration. Salts
tablets (or excess salt) also increase the risk of high blood pressure.

4.7 Health Assessment/Monitoring

4.7.1 Only fit, healthy workers will be allowed to work in conditions where severe thermal stress is
a possibility. All employees are required to undergo a health assessment prior to their
employment, or deployment to site.

4.8 Protective Clothing/PPE

4.8.1 Workers are required to wear Personal Protective Equipment (PPE), such as safety
helmets (wide brimmed hats where appropriate), safety shoes / boots, coveralls and safety
glasses (tinted for use in the sun or bright conditions). All clothing will have at least elbow
length sleeves and long trouser pants (where practical, the fabric will have a close weave).
Where possible, clothing will be lightweight, loose fitting and have a collar. PPE provides
some protection from the sun’s harmful UV rays, but does not prevent thermal stress. High
factor sunscreen will be made available for employees. Employees are responsible for
applying sunscreen before exposure to the sun.
4.8.2 Sunscreen does not offer complete protection against the sun and must always be used in
conjunction with other protective measures:

1. A broad spectrum and water-resistant sunscreen with a sun protection factor (SPF) of
30+ will be provided.
2. Expiration dates on the sunscreen will be regularly checked to ensure it has not
expired per the manufacturer’s instructions.
3. Sunscreen will be placed in an easily accessible location and employees instructed on
the correct application and use.
4. Sunscreen will be generously applied to all areas of exposed skin at least twenty
minutes before going outside and reapplied every two hours, or as need by the work
conditions.

4.9 Inspections
4.9.1 The Project SH&E Officer/SH&E Manager, will perform routine informal and formal
inspections on site to check that the requirements of this procedure are being implemented
Formal inspection will be recorded on the Thermal Stress Prevention Checklist provided as
Attachment 1.
4.9.2 The findings of these inspections will be reported to the Project and SH&E Department.

4.10 Risk Assessment

4.10.1 Prior to any work being undertaken, a risk assessment is prepared. During a job specific
risk assessment, issues such as thermal stress will be included and appropriate protection
and mitigation measures developed and implemented, where required.

4.11 In addition to the Thermal Stress Prevention and Control Measures above, the following precautionary
measures shall also be observed:
4.11.1 Provide accurate verbal and written instructions, (refer to self check urine color dehydration
indicator chart in Attachment 3, this chart is displayed in all toilet facilities), frequent training
programs and other information about thermal stress related conditions.
4.11.2 Assure co-worker observation to detect signs and symptoms of thermal stress.
4.11.3 Pay extra attention to those who take medications that compromise normal cardiovascular,
blood pressure, body temperature regulation, renal, or sweat gland functions.
4.11.4 Ensure that first aiders are properly trained in the recognition of thermal stress symptoms
and required treatment.

Heat Stress Prevention 1.1.1 C

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 4.11.5 Ensure that temperature and humidity are measured and recorded regularly (at least twice
daily).

4.12 Training & Education

4.12.1 Training is the key to good work practices. Unless all employees understand the reasons
for using new, or changing old work practices, the chances of such a program succeeding
are greatly reduced.
4.12.2 The SH&E Induction/Orientation provided to all employees will explain the causes and
symptoms of thermal stress related illnesses and injuries, minimum PPE requirements, the
need to take regular rest breaks in the shade and the need to drink plenty of water (to
replace body fluids lost through sweating) when working in hot climates and conditions.
4.12.3 Specific Thermal Stress Prevention training will be provided to all Managers and
Supervisors and will include, but not be limited to, the following components:

 Knowledge of the hazards of thermal stress.

 Recognition of predisposing factors, danger signs, symptoms and potential effects of
thermal stress related illnesses and injuries.
 Awareness of first-aid procedures for treatment of thermal stress related illnesses and
injuries, including heat stroke, heat exhaustion and heat cramps.
 Employee responsibilities in avoiding thermal stress.
 Dangers of using drugs, including therapeutic ones and alcohol in hot work
environments.
 Use of protective clothing and equipment, including application of sunscreen.
 Planning of strenuous/physical activities and hot operations for cooler periods,
wherever possible, e.g. early morning or evening/night.
 Importance of regular rest breaks, in the shade or air-conditioning, during hot periods,
as per the requirements of Section 4 of this Procedure.
 Requirement to regularly drink water or electrolyte drinks to replace body fluids lost
through sweating. Personnel should be made aware of the requirement to drink at
least 2 litres of water every 2-3 hours.
 Use of relief workers, where possible.

5.0 Records

5.1 Weekly Checklist Completion

5.2 Risks Assessments

5.3 Heat Stress Prevention Checklist (Attachment 1)

5.4 General Heat Stress Index (Attachment 2)

5.5 Heat Stress Urine Color (Attachment 3)

6.0 Attachments

6.1 Heat Stress Prevention Checklist (Attachment 1)

6.2 General Heat Stress Index (Attachment 2)

6.3 Heat Stress Urine Color (Attachment 3)

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 ATTACHMENT 1 - Heat Stress Prevention Checklist

If no, state location and mitigation

S/N Item Yes No
measure/corrective actions
Adequate ventilation provided in warehouses,
1.      
workshops and similar buildings?

2. Hot surfaces effectively insulated, where required?      

Shields used to reduce radiant heat, where

3.      
necessary?
Offices and accommodation/camp buildings cooled
4. by air-conditioners and air-conditioners working      
properly?

Appropriate shade (e.g. canopies and awnings)

5. provided over work areas, where possible, to shield      
workers from U/V rays and direct heat of the sun?

Regular (hourly) rest breaks are being taken in

6. accordance with Section 4.4 of the Heat Stress      
Prevention Procedure?

Adequate shaded areas and/or air-conditioned

7. sheds/buildings or vehicles are provided for workers      
to take rest breaks in?
8. Workers in possession of 1 litre water flask      
Adequate supplies of cold drinking water and
9. electrolyte solutions are provided in close proximity      
to all working areas?

Workers are aware of necessity of drinking water or

10. electrolyte solutions regularly (at least every 30      
minutes)?
11. Workers are aware they are recommended to drink
     
at least 2 litres every 2-3 hours?
12. Workers are not taking salt tablets?      
Workers are wearing appropriate clothing and PPE
13.      
for the conditions in which they are working?
First aiders are properly trained in the recognition of
14.      
heat stress symptoms and required treatment?
Workers understand the causes and symptoms of
15.      
heat stress (as explained in the SH&E Induction)?

Managers/Supervisors are aware of and have been

16. trained in, the requirements of the Heat Stress      
Prevention Procedure?

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 ATTACHMENT 2 - General Heat Stress Index

General Heat Stress Index

Apparent Temp.
Danger Category Heat Syndrome
(°C) (Humidity)
Extreme Danger > 54° Heat Stroke or sunstroke imminent
Sunstroke, Heat Cramps, or Heat Exhaustion likely. Heat
Danger 41°-54° Stroke possible with prolonged exposure and physical
activity.

Sunstroke, Heat Cramps, or Heat Exhaustion possible

Extreme Caution 32°-41°
with prolonged exposure and physical activity.
Fatigue possible with prolonged expose and physical
Caution 27°-32°
activity.
*Note: Degree of heat stress may vary with age, health and body characteristics

Relative Humidity

10% 20% 30% 40% 50% 60% 70% 80% 90%

50 44 52 >54 >54 >54 >54 >54 >54 >54

49 43 51 >54 >54 >54 >54 >54 >54 >54
48 43 50 53 >54 >54 >54 >54 >54 >54
47 42 48 52 >54 >54 >54 >54 >54 >54
46 41 47 50 >54 >54 >54 >54 >54 >54
44 40 45 49 >54 >54 >54 >54 >54 >54
43 39 44 48 >54 >54 >54 >54 >54 >54
42 38 43 46 >54 >54 >54 >54 >54 >54
41 38 41 45 52 >54 >54 >54 >54 >54
40 37 40 43 49 >54 >54 >54 >54 >54
39 36 38 42 47 52 >54 >54 >54 >54
38 35 37 41 43 49 >54 >54 >54 >54
(°C) 37 34 36 38 41 43 52 >54 >54 >54
36 33 35 37 40 42 49 53 >54 >54
34 32 34 35 38 41 44 50 53 >54
33 31 32 33 36 38 41 46 50 53
32 29 31 32 33 36 38 41 46 50
31 28 30 31 32 34 35 38 41 46
30 27 29 29 31 32 33 36 38 43
29 26 27 28 29 30 32 33 35 37
28 25 26 27 27 29 30 32 33 35
27 24 25 26 26 27 28 29 30 32
26 22 24 25 26 26 27 27 28 29
24 21 22 24 24 25 25 25 26 26
23 20 21 23 23 24 24 24 24 25
Example: The Temperature stands at 34 °C and the RH is now 62%. The heat stress temperature is over 44°C, in
the Danger area.

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 ATTACHMENT 3 - Heat Stress Urine Color
The color of urine tells you how dehydrated you are:

Are YOU dehydrated?

Keep on drinking water

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