As we approach the dog days of summer, heat stroke becomes a real risk. Here’s how you should prepare for outdoor work and what you should do when heat-stroke symptoms arise.


Professional football players are tough, but that doesn’t make them immune to heat-related health problems. In fact, more and more teams are outfitting training camps with kiddie pools, which is a simple way to prevent heat stroke.

If you work outside during the summer, take note of these simple ways to prevent heat-related problems.

The dangers of heat
The NFL helped start the Korey Stringer Institute at the University of Connecticut — named for the All-Pro lineman who died from heat stroke during training camp in 2001 — to conduct research, education and advocacy for the prevention of heat stroke. In the past 10 years, 30 high school and college football players have died from heat stroke.

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The same number of workers die every year, and thousands more suffer from heat exhaustion. And as areas throughout the country experience record heat, we’re reminded of an incident in Washington where a worker died of heat stroke installing a waterline.

In 2005, a newly hired 27-year-old technician, who was not acclimated to hot weather, began the work day as part of a four-man crew that was carrying and installing 12-inch PVC pipe. The crew began work around 8:30 a.m. and continued throughout the day. Temperatures ranged from 82 to 105 degrees at the job site, which was mostly exposed to direct sunlight.

The employer had provided drinking water for the workers, and it was reported the 27-year-old consumed nearly five bottles of water during the day. At about 3 p.m., he became ill and his employer suggested he rest in the shade. About 15 minutes later, his co-workers noticed he was slumped over and unconscious. Paramedics transported the victim to the hospital where he died six days later from complications related to heat stroke.

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Just as outdoor sports teams now follow rules and procedures to help acclimate players to the heat, OSHA launched its Heat Illness Prevention Campaign in 2011 to help protect workers and employers. Coaches have changed from the get-tough attitude of no water breaks to mandatory hydration and rest periods, and it’s now time for all employers to embrace a safer approach to heat safety.

Water, rest, shade
Employers are responsible for providing a safe work environment, including a program to prevent heat-related illness and fatalities. OSHA recommends that employers:

  • Provide workers with water, rest and shade: Workers should drink water every 15 minutes, even if they are not thirsty, rest in the shade to cool down, and wear a hat and light-colored clothing
  • Acclimatize new and returning workers to the heat by gradually increasing workload and providing breaks
  • Train workers about the symptoms of heat-related illnesses and their prevention
  • Monitor workers for signs of illness

According to OSHA, the most susceptible workers are those who are not used to working in the heat. The agency recommends an altered work schedule on the first day of a heat wave or for those returning to work after more than a week off.

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Protective measures

Low risk — below 91 degrees F 

  • Provide water
  • Ensure adequate medical services are available
  • Plan ahead for times when heat index is higher, including worker heat safety training
  • Encourage workers to wear sunscreen
  • Acclimatize workers

If workers must wear heavy protective clothing, perform strenuous activity or work in the direct sun, additional precautions are recommended. Direct sun increases the heat index by about 15 degrees.

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Moderate risk — 91 to 103 degrees F 

In addition to the steps listed above:

  • Remind workers to drink water often (about 4 cups/hour)
  • Review heat-related illness topics with workers
  • Schedule frequent breaks in cool, shaded area
  • Acclimatize workers
  • Set up a buddy system to watch workers for signs of heat-related illness

If workers must wear heavy protective clothing, perform strenuous activity or work in direct sun:

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  • Schedule activities when the heat index is lower
  • Develop work/rest schedules
  • Monitor workers closely

High risk — 103 to 115 degrees F

In addition to the steps listed above:

  • Alert workers of high risk
  • Actively encourage workers to drink plenty of water (about 4 cups/hour)
  • Limit physical exertion
  • Have a knowledgeable person at the work site who is well-informed about heat-related illness and able to determine appropriate work/rest schedules
  • Establish and enforce work/rest schedules
  • Adjust work activities (e.g., reschedule work, pace/rotate jobs)
  • Use cooling techniques
  • Watch/communicate with workers at all times
  • When possible, reschedule activities to a time when heat index is lower.

Very high to extreme risk — Above 115 degrees F 

  • Reschedule non-essential activity to a day or time when the heat index is lower
  • Move essential work tasks to the coolest part of the work shift; consider earlier start times, split shifts, or evening and night shifts
  • Strenuous work tasks and those requiring the use of heavy or non-breathable clothing or impermeable chemical protective clothing should not be conducted

If essential work must be done:

  • Alert workers of extreme heat hazards
  • Establish water drinking schedule (about 4 cups/hour)
  • Develop and enforce work/rest schedules
  • Conduct physiological monitoring (e.g., pulse, temperature, etc.)
  • Stop work if essential control methods are inadequate or unavailable

Watch for symptoms 

Heat exhaustion: Headache, nausea, dizziness, weakness, thirst and heavy sweating. It can turn into heat stroke quickly if immediate action is not taken.

Heat stroke: Confusion, fainting, seizures, very high body temperature, and red, hot, dry skin or profuse sweating. Requires immediate medical attention.

What to do when a worker is ill from heat

  • Call a supervisor for help. If the supervisor is not available, call 911.
  • Have someone stay with the worker until help arrives
  • Move the worker to a cooler/shaded area
  • Remove outer clothing
  • Fan and mist the worker with water; apply ice (ice bags or ice towels)
  • Provide cool drinking water, if able to drink

If the worker is not alert or seems confused, it may be a heat stroke. CALL 911 IMMEDIATELY and apply ice as soon as possible.


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