HEAT STRESS PLAN

Safety plan section No.: 12.26

Contents
Contents................................................................................................................................01
1. Purpose.................................................................................................................................02
2. Responsibilities....................................................................................................................02
2.1 Site Management, Supervisors and Foremen............................................................02
2.2 Employee.......................................................................................................................03
3. Heat Stress Danger Category......................................................................................03
4. Control of Heat Stress..................................................................................................04
4.1 Engineering Controls...................................................................................................04
4.2 Administrative Controls...............................................................................................04
4.3 Personal Protective Controls......................................................................................06
5. Training..........................................................................................................................06
Appendix-A- Heat Index...........................................................................................................07
Appendix-B...............................................................................................................................08
1. Heat Cramps..................................................................................................................08
2. Heat Exhaustion............................................................................................................09
3. Heat Stroke....................................................................................................................09
Appendix C – Dehydration Urine Color..................................................................................10
1. Urine Color ...................................................................................................................10
2. Color of concern ..........................................................................................................10
3. Best time to check .......................................................................................................10
4. Urine Color Chart..........................................................................................................10
Appendix C – Dehydration –Urine Color Chart.....................................................................11

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1 Purpose: This chapter describes minimum requirements for recognizing, evaluating and preventing heat-
related illnesses at work locations.

CDC Asasat Tabuk will strictly abide to the Country regulations, with particular reference to the “12-15” ban
generally introduced during the hottest time of the year (15 June – 15 September)

2 Responsibilities

2.1 Site Management, Supervisors and Foremen

 Providing training, counseling and education for all management levels, and workers exposed to working in
hot places with symptoms related to the heat exposure such as Heat stroke, dehydration and other, as well
as prevention methods.
 When the potential for heat-related illness exists, the environmental conditions shall monitor (e.g., air
temperature, relative humidity), the current heat stress danger categories and corresponding control
measures shall be communicate to relevant employees. See Appendix A.
 The heat stress mitigation measures shall be documented in the specific work plan, which shall specify the
specific work practices to be implemented at the site to avoid heat-related illness during periods of high
heat stress potential and may include:
 Heat stress mitigation measures shall document in the specific work plan, which shall specify the specific
work practices to be implemented at the site to avoid heat-related illness during periods of high heat stress
potential and may include:
 Scheduling the most strenuous works during the coolest times of the day (e.g. early morning and
evening/night)
 Precaution measures shall provide such as shading and local ventilation when work in direct sunlight is
required.
 Employee’s symptoms for heat-related illness shall monitor.
 Rotating workers in and out of hot areas, as possible shall implement.
 Locations of designated break/recovery areas, emergency reporting procedures and nearest medical
facilities shall communicate to workers.
 Scheduling work/rest rotations for workers according to the current heat index, which has based on
temperature and relative humidity (see Appendix A).
 Work/execution plans shall adjust (e.g., use mechanical/powered equipment to replace manual labor),
as practical.
 The schedule or productivity demands shall not supersede heat stress awareness or controls used to
prevent heat-related illness.
 Safety meetings/talks (TBT) shall be conducted periodically (e.g., weekly) during hot weather emphasizing
heat stress hazards and precautions, with added emphasis on this risk during Ramadan if it occurs in
summertime.
 Educational information related to heat stress conditions, illness/symptoms and preventive measures (e.g.,
Appendices A and B) shall be displayed on bulletin boards and break/recovery areas, etc. In addition, heat
stress information shall distribute at safety meetings/talks, etc., in a form suitable for workers (e.g.,
laminated pocket cards).
 Heat stress training and monitor new workers and workers returning from vacation shall schedule to ensure
they acclimatize at a progressive, controlled rate to the change in environmental conditions.
 Drinking water stations shall be provided (e.g., coolers with chilled or ice water) for workers and shall be
reminded them to drink plenty of water even if not thirsty.
 Drinking water shall be replenish as needed to ensure availability and collection of sanitary wastewater
from portable toilets shall be more frequented.
 Personal water bottles or insulated containers (2 liter capacity) to workers shall be provided as needed
(e.g., during high heat stress danger categories).
 Designated shaded and cool areas for periodic “cool down” breaks and recovery from minor heat-related

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 illness shall provide. Where possible, these areas are to be air-conditioned.
 The heat-related health condition of employees shall be monitored, as well as the effectiveness of any
engineering/administrative controls and personal protective equipment (PPE) being used.
 They shall be able to recognized early signs and symptoms of heat-related illness and take appropriate
action to prevent serious heat illness (see Appendix B).
 Appropriate response shall give to any heat-related illness (see Appendix B).

Everyone shall be knowledgeable of emergency reporting and response procedures, including the location of
the nearest medical facility with a qualified medical doctor/ nurse who can provide proper treatment for a victim
of severe heat exhaustion or heat stroke

2.2 Employees
 Instructions and procedures shall follow for controlling heat stress; including taking periodic “cool down”
breaks and drinking enough water (see Appendix A). Begin drinking water early in the day.
 Appropriate cloths shall be wear (e.g., light colored, lightweight, breathable, loose clothing is best).
 Food menu shall schedule (e.g. minimize the eating of meant and other heavy meals and smoking) during
the working hours.
 Reducing the drinking of fluids containing caffeine or excessive amounts of sugar
 Taking breaks at designated places of breaks.
 Ensuring to obtain enough sleep at night.
 Informing the supervisor or safety officer in case of stress or fatigue symptoms
 Everyone shall know and be alert for signs/symptoms of heat-related illnesses in themselves and others.
See Appendix B.
 Appropriate action shall take upon developing symptoms of heat cramps, heat exhaustion or heat stroke.
See Appendix B.
3 Heat Stress Danger Category
When the potential for heat-related illness exists, the actual heat index (see Appendix A) shall be
periodically determined (e.g., every hour) at the work site using calibrated weather monitoring equipment
provided by the employer (e.g., the contractor company)
The heat stress danger category shall be, obtained from the current heat index (see Appendix A), and shall
be declared at the job site when the potential for heat related illness exists.
The heat stress dangerous category (see Appendix A) shall use to determine control measures as specified
in upcoming action of this chapter.
The current heat stress danger category and corresponding control measures shall be communicated to
employees as conditions change (e.g., by use of color-coded flags, information signs, mass distribution of
SMS mobile phone text messages to site supervisors and other personnel in site ).

4 Control of Heat Stress

During periods of high heat stress potential (i.e., danger category III or IV in Appendix A) at the work site,
the following measures shall implement as applicable to control heat stress. As with any hazard, feasible
engineering controls are the primary control measure, followed by administrative (work practice) controls
and personal protective controls, in that order of preference.

4.1 Engineering Controls

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 A. Shade
Designated shaded break/rest areas shall provide at a distance shall not more than 100 m (330 ft.) from
personnel work in direct sunlight for extended period. When feasible, shade to shall provide for work
areas, including single shades to accommodate flagmen, etc.
B. Local Ventilation
When the air temperature is less than 37 °C (99 °F), fans or portable air movers may be used to reduce
heat stress by increasing the airflow in the work area.
C. Portable Air Cooling Systems
Portable blowers with built-in air chillers shall be used as needed (e.g. When confined spaces and
enclosed work areas have ambient temperatures exceeding 43 °C [110 °F]) to provide cooling for confined
spaces and similar enclosed work areas

4.2 Administrative Controls

A. Scheduling
Work for the cooler times of the day shall schedule, especially during the month of Ramadan if it falls in
the summer.
B. Acclimatization
Deliberate acclimatization shall use to expose new employees to work in a hot environment for
progressively longer periods. New employees in jobs where heat levels may produce heat stress shall
expose to 20% of normal exposure on day one, with a 20% increase in exposure each additional day.
C. Water Replacement (Hydration)
Workers shall be encouraged to drink plenty of water prior to the start of each shift. Ample supplies of cool
drinking water shall be located within100 m (330 ft.) walking distance of each worker and in all designated
break/rest areas. Workers shall drink small amounts of water on a frequent basis based on the actual heat
index at the work site (see Appendix A).Sports drinks, juices and electrolyte replacement/rehydration
mixes may also be made available to workers in order to help maintain the body’s water and salt levels.
However, workers shall not consume more of these drinks than plain water. Workers shall not take salt
tablets due to potential adverse side effects (e.g., nausea/vomiting, dehydration).
D. Work/Rest Rotations
Work and rest rotations shall base on the actual heat index at the worksite. See Appendix A. Work
rotations shall be established for workers performing remote activities in high heat stress exposures (e.g.,
flagmen).Workers shall be allowed additional break time and water as they deem necessary for their
health.
E. Personal Monitoring
Employees shall work in teams and shall observe each other for signs of diminished capacity and heat-
related illness. Prescribed check times and monitoring controls shall use to determine whether a worker is
experiencing diminished capacity or symptoms of heat stress.

F. Red Heat Stress Danger Category IV Work Practices

The following additional precautions shall take while a red heat stress danger category IV, “Extreme
Danger,” (see Appendix A) exists at the work site:
 Contractor site management shall assess the risks associated with work to perform in direct
sunlight for an extended period. Based on the resulting risk assessment, CDC-Asasat Tabuk with
DDC management shall determine if the work shall continue if it does not fall in the following
categories: (1) deemed necessary for continuing plant operations, (2) emergency maintenance or
(3) rescue operations.
 Engineering controls such as shade and ventilation/cooling systems are required for work activities
that involve increased risk (e.g., work in confined spaces, at elevated locations or involving high

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 physical exertion).
 Workers exhibiting symptoms of serious heat-related illness shall immediately seek medical
attention and allow to fully recovering before returning to work.
 Workers shall be provided break periods during work activities. The duration and number of
breaks shall established during the daily work planning based on type of work activities and
control measures provided. Work durations shall monitor to ensure proper breaks are take.
 Workers shall advise to drink one cup of water every 10 minutes. Each worker shall be provided
with his own personal water bottle/insulated container (2 liter capacity) and have it with him at all
times. A “no water, no work” policy shall be strictly adhered to.
 No person shall work alone (i.e., isolated) while a red heat stress danger category IV condition
exists at the work site.
 Extra precautions shall be taken when flame-resistant clothing (FRC) are required to be worn
while a red heat stress danger category IV exists at the work site, as such fabrics can intensify
heat stress. other types of fabrics, which may increase the heat stress (e.g., polyester, nylon),
shall not be wear while a danger category IV exist at the work site.
 Ambulance and with nurse shall be available on site while work is going on Red Heat Stress
Danger Category
G. Recovery
Any employee experiencing symptoms of a heat-related illness (see Appendix B) shall allowe to fully
recover in an appropriate recovery area before returning to work. Recovery areas shall be shaded, cool
and supplied with water. Victims of severe heat exhaustion or heat stroke shall immediately evacuate to
the nearest medical facility with a qualified medical doctor who can provide proper treatment. Such
incidents shall properly report.
H. Special Considerations during Ramadan
Appropriate planning and heat stress mitigation measures shall incorporate into the specific work plan
(e.g., Job Safety Analysis) for workers who are fasting during Ramadan if it occurs during the summer.
Supplies of cool drinking water shall make available for workers as needed during Ramadan (e.g., for a
worker experiencing symptoms of a heat-related illness).
I. Other Administrative Controls
Other administrative controls shall be used as appropriate to reduce heat stress, including using
powered equipment to replace manual labor, limiting worker occupancy duration within confined areas
and modifying work plans.

4.3 Personal Protective Controls

A. Ice Cooling Garments
Commercially available ice vests, neck/wrist wraps, etc., may provide to employees as needed (e.g.,
who work for extended periods inside a confined space during hot weather). Ice packets shall replace
as required.
B. Clothing
Light colored, lightweight, breathable clothing that covers as much of the body as possible, including
the head, shall be worn when working in direct sunlight. Since FRC and other synthetic fabrics (e.g.,
polyester, nylon) increase heat stress, appropriate planning and mitigation measures shall incorporated
into the specific work plans (e.g., Job Safety Analysis) for personnel wearing this type of clothing while
working in conditions with a high heat stress potential.
C. Wetted Clothing/Towels
During periods of high heat stress potential, employers are to provide employees with wetted terry cloth

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 towels and/or allow them to wet their normal work clothes as necessary to provide cooling for their
body. Cool water supplies (not ice water) separate from drinking water shall use for this purpose (e.g.
containers of clean water with a faucet/spigot for sanitary distribution, instead of dipping).
5 Training
 Heat stress awareness training shall be provided just before and during the hot summer months to all
applicable personnel (e.g., who work outdoors) and those who manage personnel and have
responsibilities for establishing heat stress mitigation measures.
 Heat stress awareness training shall include the following elements:
 Hazards of heat stress.
 Heat stress signs and symptoms recognition see Appendix B
 Heat stroke and other heat related illnesses first aid procedures.
 Employee responsibilities in avoiding/responding to heat-related illness
 Supervisor responsibilities in avoiding/responding to heat-related illness
 Dangers of the use of drugs including prescription and over the counter medicine in the hot
environments
 Measures employees can take to minimize the effects of heat stress (hydration, work pace, use
of wet towels, good nutritional habits, etc.).
 Personal monitoring and buddy system controls
Note:
Training shall emphasize that heat stress can affect an individual’s ability to reason clearly. This may
cause a person to fail to recognize the signs and symptoms of heat stress. For this reason, self-
monitoring shall augment by prescribed check times and monitoring controls. Check times are intervals
at which a heat stress-trained supervisor or observer (including a coworker) checks to see if there are
obvious symptoms of heat-related illness or if there is any sense of diminished capacity in himself and
his coworkers, rather than waiting for symptoms to appear.
First aid and other emergency responders shall properly train in the recognition and treatment of heat-
related illnesses.

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 Appendix B
1. Heat Cramps
Although heat cramps are not dangerous, they are an early warning sign for heat exhaustion and that the body’s
ability to cope with heat has being exceed
Causes:
 Occurs when the body loses too much salt through sweating
 Attributed to an electrolyte imbalance caused by sweating.
Symptoms include:
 Painful cramping of the muscles (e.g., arms, legs or stomach).
 Hot, moist skin
 Slightly elevated body temperature
Treatment includes:
 Stop all activity.
 Rest in a cool, shaded area (e.g., designated break/recovery area).
 Loosen clothing.
 Drink water.
 If symptoms persist, seek medical aid.
Another early indication that heat stress conditions may be present is the appearance of heat rash, which is an itchy rash
that occurs when the skin becomes swell and plug the sweat glands. This is not a life-threatening condition.
2. Heat Exhaustion
Heat exhaustion is the body’s response to an excessive loss of water and salt by sweating. Heat exhaustion poses a
higher risk to older employees and those with coronary artery disease or emphysema (a lung condition causing
breathing impairment).
Causes:
 Occurs when the fluids and/or salt lost in sweating are not replace
 Enlarge surface blood vessels.
Symptoms include:
 Heavy sweating
 Intense thirst and cool, moist skin
 Weakness and dizziness
 Headache and blurred vision
 Nausea and vomiting
 Pale or flushed appearance
 Mood changes such as irritability or confusion.
 Rapid pulse
 Fainting
Treatment includes:
 Move the victim to a cool, shaded area (e.g., designated break/recovery area).
 Call for medical help.
 Loosen the victim’s clothing.
 Remove unnecessary clothing.
 Shower or sponge the victim’s skin with cool water.
 Have the victim drink water or sport drinks that have electrolytes (e.g., Gatorade).
Notes:
 Heat exhaustion can rapidly progress to heat stroke if not properly treated. People suffering from heat
exhaustion must not be expect to take care of themselves because they may lack coordination and become
confused. Heat exhaustion requires fast response to prevent worsening heat stress problems.
 Remember that sweating only cools the body if the sweat evaporates. If it cannot evaporate, it cannot cool. Thus, even
under moderate or cool working conditions, it is possible to suffer heat stress if you are inside protective clothing that
interferes with your body cooling or working in high-humidity conditions.
3. Heat Stroke
Heat stroke is a medical emergency and death or permanent tissue damage may occur if treatment is not give
promptly. Collapse often misinterpreted as a heart attack or head injury.
Causes:
 Occurs when the body no longer sweats and holds so much heat such that the body’s system of temperature

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 regulation fails and body temperature reaches dangerous levels.
 Body depleted of salt and water.
Symptoms include:
 Dry, hot skin with no sweating
 High body temperature (above 40 °C [103 °F])
 Strong, rapid pulse
 Chills
 Weakness, nausea, vomiting
 Mental confusion
 Seizures or convulsion
 Collapse, loss of consciousness
Treatment includes:
 Immediately call or arrange for professional medical help.
 Cool the victim down as much as possible while waiting for medical help.
 Move the victim immediately to a cool, shaded area.
 Loosen or remove heavy clothing.
 Have the victim lie flat with feet elevated.
 Fan and mist the victim’s body with water.
 Monitor the victim breathing.
 Have the victim drink water or sport drinks that have electrolytes (e.g., Gatorade). Do not give fluids if
the victim is unconscious.
Notes:
 Sometimes, heat stoke occurs after the person has already developed heat exhaustion, but heat stroke can
also strike suddenly with little warning.
 Regardless of the worker’s protest, no person suspected of being ill from heat stroke shall sent home or left
unattended unless/until a medical doctor has specifically approved such an action .

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 Appendix C – Dehydration Urine Color
1. Urine color
Hydration issues can determine from urine colors. The color of urine is a great barometer it can determine
the level of hydration. If it’s clear or straw-colored, then you’re drinking sufficient fluid. If it becomes dark
yellow or brown, then you are likely somewhat dehydrated,

2. Color of concern
Sometimes urine will turn pinkish a few hours after you have eaten foods with intense red color, such as beets,
blackberries and rhubarb. However, your urine should return to normal within a day.

3. Best time to check

It has recommended checking twice a day in the morning and right before bed.

4. Urine color chart

The chart will help the individuals to determine the condition of dehydration in body. Self-inspection of urine
color against the chart will provide advice on the level of dehydration and the recommended water intake to
return the body to a normal level of hydration.
Overall, to be safe, it is recommend that individuals drink 2 liters of water every 2 to 3 hours when working
continuously outside

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