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Summer is here – and with that – so is an increased risk in heat stroke, heat related illness and heat-stress related injuries in Hampton Roads.  With that in mind, here is a review on treatment, prevention, and risk reduction regarding heat illnesses.


Heat stress is a buildup of body heat generated either internally by muscle use, or externally by the environment.  Heat exhaustion & heat stroke result when the body is overwhelmed by heat.  As environmental heat increases, body temperature & heart rate can rise unnoticed.  The human body rids itself of excess heat to maintain constant body temperature.  Sweating is the primary means which humans control a constant body temperature.  Sweat cools by evaporation, releasing heat from the body.  Sweating does not cool the body unless moisture is removed from the skin by evaporation.

When environmental temperatures approach normal skin temperature (98°F), cooling the body becomes difficult.  Under conditions of high humidity, evaporation of sweat from the skin is decreased, and the body’s efforts to maintain body temperature is impaired.


The frequency of accidents in general appears to be higher in hot environments.  Heat tends to promote accidents because of sweaty palms, dizziness and fogging of safety glasses.  Mental confusion, tiredness and irritability may occur when an employee becomes overheated, resulting in poor judgement & unsafe practices; an increase in body temperature of just two degrees Fahrenheit can affect mental functioning.


  • Dehydration and Fatigue and Improper work methods
  • Infrequent exposure to hot temperatures & high humidity
  • Age over 40 (due to the diminished ability to sweat as we age)
  • Poor physical condition or overweight / obese
  • Use of certain medications (antihistamines, diuretics, tranquilizers, etc)
  • Having certain medical conditions (diabetes, pregnancy, kidney disease, etc)
  • Prior episodes of heat exhaustion or heat stroke
  • Use of drugs and/or alcohol within the preceding 24 hours
  • Having a heat rash or sunburn
  • Wearing restrictive clothing or too much clothing


Heat Rash

  • Also known as “Prickly Heat”; occurs when sweat ducts become clogged, resulting in a rash
  • Looks like a cluster of red pimples or small blisters; appears on the neck, upper chest, groin
  • Rash area should be kept dry; powder may be applied to the rash to increase comfort
  • Ointments & creams should NOT be used on a heat rash (may make the rash worse)
  • Occurs in hot, humid environments where sweat does not easily evaporate from the skin
  • Can be very uncomfortable if the rash is extensive, or complicated by infection
  • Prevented by taking breaks in a cool place during the work day & drying the skin regularly

Heat Cramps

  • Painful muscle spasms caused by sweating while doing hard physical labor in heat
  • May occur alone or simultaneously with other heat-related illnesses
  • May be caused by either too much – or too little – salt
  • Tired muscles are very susceptible to heat cramps
  • Occur most commonly in the forearms, legs (calf muscles), back or abdominal muscles

Treatment: drink cool, lightly-salted water or commercial fluid-replacement beverage and seek medical aid if the cramping is severe or doesn’t go away


  • Occurs when employees (not used to the heat) stand in one position for an extended period
  • An employee who has fainted should recover after a brief period of sitting or lying down
  • Moving around rather than standing still will reduce the possibility of fainting

Treatment: same as “Heat Exhaustion” below

Heat Exhaustion

  • Caused by loss of large amounts of fluid by sweating, sometimes with excessive loss of salt
  • Heat exhaustion victims still sweat, but may also experience any of the following symptoms:
    • Weak & rapid pulse greater than 100 beats per minute
    • Low blood pressure less than 100/60 mmHg
    • Body temperature greater than 100.4°F
    • Headache, dizziness, weakness, nausea and/or vomiting
    • Pale, cool & “clammy” – but moist – skin
    • Decreased – and dark colored – urine
    • Confusion, irritability, clumsiness & easily upset, light-headedness, or fainting

Treatment move the victim to a cool area; provide cool water to drink; cool the victim by fanning them; cool the victim’s skin by directly applying a wet cloth or wet towel or wet sheet; lay the victim on his or her back & raise the victim’s legs 6 to 12 inches (while keeping the head & shoulders slightly elevated) if he or she is dizzy; lay the victim on his or her side if vomiting occurs; loosen & remove heavy clothing and stay with the victim; Call for emergency help if the victim does not feel better in 30 minutes; If heat exhaustion is not treated, the illness may advance to heat stroke

Heat Stroke

The most serious heat related illness; results in death in approximately 20% of all cases.  The lingering effects after a heat stroke victim recovers include varying degrees of brain, heart, liver, kidney and muscle damage, nervous system problems & blood disorders occurs when the body’s temperature regulating system fails & sweating cannot remove excess body heat.

  • Heat Stroke victims may also experience any of the following symptoms:
  • Body Temperature greater than 105°F
  • No sweating; hot, red skin
  • Irritability, confusion, strange & distressed behavior, and incoherent speech
  • Collapse, unconsciousness, and seizures

Treatment:  The same first aid as for someone suffering from heat exhaustion, plus…

  • Call for emergency help / 911
  • Lay victim on his or her back (unless unconscious, then lay them on their side)
  • Remove any objects close to the victim in case they have a seizure
  • If conscious, provide cool water to drink
  • Place ice packs under the victim’s armpits, in the groin area, and on the neck
  • Do NOT give the victim aspirin or Tylenol


Humans are capable of adjusting to the heat; gradual exposure to heat over progressively longer periods gives the body time to adjust to higher temperatures.  This process takes about 5-7 days, with gradual increase in work about 20% per day.  Heat-related illnesses will likely occur among employees who have not been given time to adjust to, or who have been away from, hot environments.


  • Schedule the hardest work during the coolest part of the day
  • Encourage the “buddy system” (employees work in hot conditions in pairs)
  • Drink plenty of clear liquids – and often – BEFORE you are thirsty
  • Provide plenty of cool water & encourage drinking a cup every 15 to 20 min.
  • Wear light-colored, loose fitting, lightweight & breathable (cotton) clothing
  • Take frequent (every 2 hours) short breaks (about 10-15 min) in cool areas
  • Avoid eating large meals during work in hot environments
  • Avoid caffeine and alcohol before – and during – work in hot environment


Drink at least 1 quart (= approximately 1 liter) of water per hour (or, an 8oz glass of water every 15 to 20 minutes).  It’s better to drink small amounts frequently, as opposed to larger amounts less often.  Drink, even if you don’t FEEL thirsty.  Avoid drinks like sodas or coffee that have caffeine, or alcoholic drinks (these drinks dehydrate you & can make it more dangerous to work in the heat).  Avoid sports drinks, as these contain too much sugar.

People worry that if they drink a lot of water, they’ll have to go to the bathroom more often – In fact, you’ll mostly sweat it off.  When you’re not at work, still drink plenty of water to help your body recover from the work day.

More Questions?

If you have more questions about preventing and treating heat related health concerns in your work environment contact us at (757) 494-1688. One of our health specialists will be happy to help you.

Download OSHA Fact Sheet – Protecting Workers from the Effects of Heat

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