How much of a problem is heat-related injury for construction workers?

Across the population of Abu Dhabi in 2010 – for all ages and nationalities – there were 3017 cases of heat related illness treated in Emergency Departments in the Emirate of Abu Dhabi most of them (66%) from heat exhaustion with heat stroke accounting for 4% of the total cases.

Not all cases were work related but the majority (63%) were from Bangladeshi, Indian and Pakistani nationals, indicating they were probably work related.

In 2010 there was one fatality from heat exposure from the HAAD death notifications in Abu Dhabi, but potentially other workplace fatalities could be caused by heat exposure and result in falls from heights and other workplace incidents that result in fatal injuries.

This is however not recorded as a heat-related fatality so this is unknown at present.

Heat exposure is a widespread problem and anyone who works outdoors or in an open environment, even under shade, without air conditioning is exposed to severe heat stress in summer. This includes many occupations including construction workers but also agricultural workers, road cleaners and municipal workers, window cleaners, service station attendants and many, many more.

Precautions need to be taken by all sectors and companies who employ workers outdoors and should not only be limited to construction companies.

What can workers and employers do to prevent injury and illness?

Employers have a legal responsibility to protect the health and safety of their workforce and should provide training and awareness as well as adequate protection for all exposed workers for this occupational hazard and the risks involved.

However it is a shared responsibility with managers, supervisors and even workers who should receive training in, and be enabled to carry out, the responsibilities required of them.

Do employers do enough to protect workers?

Some employers do implement the required control measures and address heat stress and exposure as an important occupational hazard that needs to be managed.

Other employers do not adequately address this issue and this itself is being addressed by government authorities, including the Federal Ministry of Labour, the Health Authority Abu Dhabi (HAAD)  and the Abu Dhabi Environmental Health and Safety centre (EHS), as well as the various sector regulatory authorities,  who are all working to educate, create awareness and enforce the requirements of both federal and local law.

It is the responsibility of employers to raise awareness of this issue and provide adequate facilities and resources to workers to protect their health. To adequately address heat stress it is best to manage this holistically and implement a variety of measures.

PowerPoint presentations for trainers and workers have been developed for this purpose and are available on the HAAD Safety in Heat Website at www.haad-safe.ae;

The information below is what we advise in the HAAD safety in the heat programme and gives guidance on the various aspects related to the management of heat stress that HAAD recommends.

Employers are responsible for ensuring:

• A risk assessment is performed to determine what hazards exist that could cause employees to suffer heat related illness.
• Engineering controls are implemented to eliminate the hazard as far as practicable.
• An effective heat stress programme as outlined below is implemented.
• That the UAE Ministry of Labour’s requirements for a midday break during the summer months for employees working outside is adhered to. There should also be an effective heat stress programme implemented at all worksites where employees are exposed to heat stress.

Managers and Supervisors are responsible for ensuring:

• The employer’s heat stress programme is implemented successfully;
• All heat exposed employees are adequately trained in a language they understand;
• Adequate availability of sufficient water for the employees to maintain hydration levels;
• An allowance is made for self-pacing of work and adequate rest breaks are provided to exposed workers;
• That in the event an employee is suffering from a suspected heat related illness they have immediate access to medical attention;

Employees are responsible for ensuring:

• They participate in any required training required by the employer or supervisors in regards to heat stress and work in hot environments;
• That they know the requirement of their employer’s heat stress program and obey the requirements of the programme;
• They report any failures of the heat stress programme to their supervisor immediately; and
• They report any symptoms of heat illness suffered by themselves or fellow employees to their supervisor immediately.

Heat Stress Program Requirements

Employers must perform a risk assessment, to identify high temperature working environments and implement effective controls to reduce exposure and protect employees from heat exposure as far as is practical.

Employers that have employees working in high temperature environments shall develop a heat stress programme that will consist of but not be limited to the following elements:

• Acclimatisation programmes for new employees, employees that have been on vacation; and employees that are moving from a worksite that has climate control to a worksite that has high temperatures with an allowance of five to seven days for acclimatisation before starting hard work in a hot environment in summer;
• Process for assessing environmental conditions to understand the precautions to be taken to manage heat stress and exposure in the environment. HAAD along with an Australian university has developed a heat stress index called the Thermal Work Limit (TWL) index and the output is linked to control zones with specific requirements to manage exposure more info is available at the HAAD safety in heat website at www.haad-safe.ae;
• Communication system to inform/remind employees, employees returning from vacation and visitors to the site of the hazards of heat stress, signs and symptoms of heat stress, and steps to be taken to prevent heat stress;
• Implement a system to communicate current environmental conditions to employees so they can take the appropriate actions to prevent heat stress injuries and illnesses;
• Requirements for provision of adequate amounts of drinking water close to the worksite and suitable electrolyte replacement drinks for employees working in high temperature environments. Implement programmed drinking where appropriate every hour to encourage adequate fluid intake;
• Provision of appropriate clothing (lightweight, cotton, light-coloured, loose-fitting -unless using machinery – and personal protective equipment including a large personal water container of at least 1-2 litres in size;
• Provision for design and placement of shade and cooling shelters for employees working outside during summer months and suitable cooled accommodation/shelter for the summer months during the midday break periods set by the Ministry of Labour;
• Provision of pre-employment screening and medical clearance for work in heat for any employee with a chronic medical condition (e.g. high blood pressure, obesity) or requiring the use of prescription drugs which may affect their resistance to heat stress (consult a doctor).
• Pre-job training and inductions – prior to working in high temperature environments – and a ‘permit to work’ system in extreme high temperature and humidity environments;
• Audit/Inspection program to ensure worksites are following the heat stress programme requirements;
• Training for all employees as indicated below;
• Investigation and reporting on heat injuries and illness as required by the UAE labour law and the Abu Dhabi EHSMS requirements;

(a)    Whenever feasible, engineering controls shall be used to eliminate/reduce the heat exposure. Possible controls include:

• Insulation of ceilings to minimize solar heat transfer;
• Providing shaded work areas;
• Providing cooled and air-conditioned rest areas with water or electrolyte drinks available;
• Using exhaust ventilation such as extraction hoods above heat-generating processes like a furnace or oven to remove heat;
• Using forced air-ventilation such as fans to increase airflow across the skin and increase evaporation and cooling;
• Using cooled air from an air-conditioning system;

(b)   Work is to be planned so that an adequate number of workers are acclimated and prepared to work in a high temperature environment.

(c)    Workers shall not work alone in extreme heat stress areas.

(d)   Personal Protective Equipment should be provided where required.

(e)   Sufficient cool fluids shall be available and accessible by workers to maintain adequate hydration during periods of heat stress;

(f)     Hydration testing may be conducted to using urine specific gravity to ascertain individual worker hydration levels and implement appropriate rehydration regimes;

(g)    Workers in high temperature environments shall be provided a cooler area to rest during breaks in order to reduce body heat.  Duration of breaks, extent of clothing removal, and rest area shall be appropriate for conditions at the site

(h)   Employers with high temperature work environments shall implement the following protocol in case of dehydration or heat illness:

• If a worker begins to feel symptoms of heat illness or dehydration the recommended dehydration and heat illness protocols should be followed.
• Fellow employees and/or supervisors should be trained to provide first aid and call for additional emergency medical assistance if required or if the employee complains of chest pains, or has symptoms of heat stroke;
• Identify and implement heat stress controls for high temperature environments in the planning stages of a project. Adjusted work hours and the use of body cooling devices may be considered;
• Evaluate employer supplied meals to ensure that they offer a health balanced diet with adequate nutrition and sufficient electrolytes and calories to sustain work in high temperature environments;
• Encourage workers to avoid consumption of alcohol, tea, coffee and caffeinated drinks and drink plenty of hydrating liquids in the 24 hours prior to reporting to work and before arriving at work.

Training and Awareness is very important and:

Employers have a responsibility to raise awareness of the dangers of heat stress and the precautions to be taken to protect the workforce from heat stress and heat illness. General working in heat awareness should be undertaken to cover:

• An induction of all personnel new to the GCC region, regardless of origin should include Working in Heat information. PowerPoint presentations for trainers and workers have been developed for this purpose and are available on the HAAD Safety in Heat Website at www.haad-safe.ae;
• Prior to the hot season each year, a brief follow up talk to all workers reinforcing the importance of maintaining good hydration and recognizing the signs of heat illness;
• Sufficient information given to workers (in a language they understand) and awareness regarding heat as a hazard and precautions to be taken and posters, information leaflets, training videos and presentations etc. used prior to and throughout the summer months to raise awareness and maintain awareness amongst the workforce exposed to extreme heat conditions.
• Posters illustrating monitoring of hydration status by urine colour should be displayed in toilets and rest rooms.

Employees should be trained on:

• how to recognize the signs and symptoms of heat related illness in themselves and others and how the body overheats;
• the importance of drinking water (at least 2 liters every 2-3 hours) and the addition of salt to meals;
• How to monitor urine color to determine hydration levels;
• the importance of acclimatization, work pacing, rest breaks and effects of clothing on heat stress;
• the procedures to call for first aiders and/or medical assistance;
• the requirements of the employer’s heat stress program;

Managers and Supervisors should be trained on:

• how to recognize the signs and symptoms of heat related illness and how the body overheats;
• the precautions to be taken for the prevention of heat related illness amongst the workforce;
• the importance of self-pacing and providing adequate rest breaks for recovery;
• the procedures to call for first aiders and/or medical assistance
• the requirements of the employer’s heat stress programme

First Aiders should be available and trained on:

• how the body overheats and how to recognize the signs and symptoms of heat related illness and the different types of heat related illness;
• the precautions to be taken for the prevention of heat related illness;
• the first aid treatment of the different types of heat related illness;
• the procedures to call for medical assistance;
• the requirements of the employer’s heat stress programme.

The Health Authority Abu Dhabi has developed a programme for training and awareness for all the required target groups and has provided free resources for companies to access and use to train their workforce.

The resources are free to download upon registration at the HAAD safety in heat website at www.haad-safe.ae and Abu Dhabi based companies can collect hard copies of the materials upon registration.

Softcopies are available for free download to anyone who registers and includes resources for Health and Safety personnel, supervisors, workers in different languages and includes posters, pamphlets, training resources and videos.