Heat Illness Toolbox Talk
Heat stroke is the one jobsite emergency where the wrong decision in the first ten minutes is the difference between a bad afternoon and a death.
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The talk, read this out
Look at who is new on this crew this week. New workers are the ones who die of heat, and that is not an opinion, it is what the investigations keep finding.
Water, rest, shade. Everything else in this talk is detail. Water before you are thirsty, roughly a cup every fifteen or twenty minutes in the heat, rest in the shade before you feel bad, not after.
Acclimatization is the part nobody plans for. It takes about a week to two weeks of gradually increasing exposure for a body to adapt. A large share of heat deaths happen in a worker's first few days on the job or on the first hot day after a cool spell. New people, people back from vacation, and everybody in the first heat wave of the season get a lighter first few days.
Know the two stages. Heat exhaustion is heavy sweating, cool clammy skin, weakness, dizziness, nausea, headache and a fast weak pulse. That person stops work, goes to shade, loosens clothing, drinks and gets cooled. They do not go back to work that day.
Heat stroke is different and it is a medical emergency. Confusion, slurred speech, stumbling, no longer sweating in some cases, hot red skin and a body temperature that is climbing. Call 911, get them into shade, get cold water and ice on them at the neck, armpits and groin, and start cooling immediately while you wait. Do not wait for the ambulance to start cooling.
The sign everybody misses is confusion. Somebody who is suddenly argumentative, does not answer properly, or is doing the task wrong in a way they never do. That is a brain running too hot, and it is the last warning before collapse.
Watch each other, because the person overheating is the last to know. Buddy up in the afternoon, and nobody works alone in extreme heat.
Point at these before anybody starts
A talk delivered in a trailer is a meeting. Stand where the work is and put a hand on each of these.
- Where the water is, and whether there is enough of it for the whole shift
- Where the shade is. If there is none, where the shade is going to be built
- Who is new this week, and what their lighter schedule is today
- The forecast high, the humidity and when the hottest part of the day hits
- Where the ice is, and who is calling 911 if it comes to that
- The buddy pairs for this afternoon
The rules that apply
- Water available at all times, cool, and close enough that people actually drink it. A cup every 15 to 20 minutes.
- Shade or an air conditioned space for breaks, and breaks taken before symptoms start.
- New and returning workers get a gradual build up over the first week or two. Roughly 20 percent of a full shift on day one is the NIOSH model for unacclimatized workers.
- Heat exhaustion means stop, cool, hydrate and do not return to work that shift.
- Heat stroke means call 911 and start aggressive cooling immediately with ice and water, not later.
- Nobody works alone in extreme heat. Watch each other for confusion and stumbling.
Ask the crew
Three questions, answered out loud by name. This is the part that tells you whether anybody was listening.
- Who here is in their first week on this job or back after time off?
- How much water have you had this morning, honestly?
- If somebody goes down at two o'clock, who calls, who cools and where is the ice?
Close with this
Drink before you are thirsty, rest before you feel bad, and if somebody is confused it is an emergency, not a break.
A talk nobody signed for is a talk that, as far as anybody can later prove, never happened. Use the free toolbox meeting sign in sheet in PDF, Word or Excel, or print the PDF above, which already has the signature lines on it.
Questions people ask
Does OSHA have a heat standard for construction?
There is no specific federal heat standard yet. Heat hazards are enforced under Section 5(a)(1) of the OSH Act, the General Duty Clause, and several states including California, Washington, Oregon, Colorado and Minnesota have their own heat rules with specific water, shade and rest requirements.
What is the difference between heat exhaustion and heat stroke?
Heat exhaustion has heavy sweating, cool clammy skin, weakness and nausea, and the person is thinking clearly. Heat stroke involves confusion, slurred speech or loss of consciousness, hot skin and a rising core temperature. Heat stroke is a 911 call and immediate cooling.
How long does it take to get used to working in heat?
Roughly one to two weeks of gradually increasing exposure. NIOSH suggests about 20 percent of the usual workload on the first day for unacclimatized workers, increasing by no more than 20 percent per day. Acclimatization is lost after about a week away.
More toolbox talks
TOOLBOX TALK: HEAT ILLNESS
Attendance
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