Monday, March 30, 2015

Heat-related Illnesses and First Aid

Heat stroke, the most serious form of heat-related illness, happens when the body becomes unable to regulate its core temperature. Sweating stops and the body can no longer rid itself of excess heat. Signs include confusion, loss of consciousness, and seizures. "Heat stroke is a medical emergency that may result in death! Call 911 immediately.
Illustration of a man's head who sweating Heat exhaustion is the body's response to loss of water and salt from heavy sweating. Signs include headache, nausea, dizziness, weakness, irritability, thirst, and heavy sweating.
Illustration of a leg which denotes cramping Heat cramps are caused by the loss of body salts and fluid during sweating. Low salt levels in muscles cause painful cramps. Tired muscles—those used for performing the work—are usually the ones most affected by cramps. Cramps may occur during or after working hours.
Heat rash, also known as prickly heat, is skin irritation caused by sweat that does not evaporate from the skin. Heat rash is the most common problem in hot work environments.
The chart below shows symptoms and first aid measures to take if a worker shows signs of a heat-related illness.

Symptoms First Aid*
Heat stroke
  • Confusion
  • Fainting
  • Seizures
  • Excessive sweating or red, hot, dry skin
  • Very high body temperature
  • Call 911
While waiting for help:
  • Place worker in shady, cool area
  • Loosen clothing, remove outer clothing
  • Fan air on worker; cold packs in armpits
  • Wet worker with cool water; apply ice packs, cool compresses, or ice if available
  • Provide fluids (preferably water) as soon as possible
  • Stay with worker until help arrives
Heat exhaustion
  • Cool, moist skin
  • Heavy sweating
  • Headache
  • Nausea or vomiting
  • Dizziness
  • Light headedness
  • Weakness
  • Thirst
  • Irritability
  • Fast heart beat
  • Have worker sit or lie down in a cool, shady area
  • Give worker plenty of water or other cool beverages to drink
  • Cool worker with cold compresses/ice packs
  • Take to clinic or emergency room for medical evaluation or treatment if signs or symptoms worsen or do not improve within 60 minutes.
  • Do not return to work that day
Heat cramps
  • Muscle spasms
  • Pain
  • Usually in abdomen, arms, or legs
  • Have worker rest in shady, cool area
  • Worker should drink water or other cool beverages
  • Wait a few hours before allowing worker to return to strenuous work
  • Have worker seek medical attention if cramps don't go away
Heat rash
  • Clusters of red bumps on skin
  • Often appears on neck, upper chest, folds of skin
  • Try to work in a cooler, less humid environment when possible
  • Keep the affected area dry
* Remember, if you are not a medical professional, use this information as a guide only to help workers in need.

Thursday, March 19, 2015

Eyewash equipment

Mr. M****

Safety Director
Motion Picture and Television Safety Committee
Hollywood, California 90048

Dear Mr. M***:

This is in response to your letter of July 8, 1982, petitioning for a change in the Occupational Safety and Health Administration (OSHA) standards to permit the use of readily available eyewash equipment, in some situations, as a substitute for using protection, as well as your recommendations for expanded requirements covering the location and accessibility of eyewash equipment.

I would be interested in receiving copies of the research you mentioned which seemed to indicate that protective eyewear and face shields cause eye problems, irritation and headaches. My office is aware of isolated complaints, but does not have research material indicating this to be a problem. In fact, the research material which we possess indicates protective eyewear to have optical qualities of an acceptable level (see pages 124-177 of enclosed report). Additionally, overall optical characteristics of protective eyewear exceed those of prescription eyewear.

Regarding your suggestion of substituting portable eyewash equipment for eye protection, we do not view this as equivalent protection. The purpose of the protective eyewear is to prevent the accident, whereas the purpose of eyewash facilities is to minimize the injury should the first line of defense fail to do the job.
Your suggestions relative to better defining the requirements for eyewash facilities seem appropriate. I am providing a copy of your letter to Dr. Leonard Vance, Director, Directorate of Health Standards for consideration by his staff who have responsibility for Section 1910.151.


Barry J. White
Directorate of Safety Standards Programs

Wednesday, March 11, 2015

Interpretation of First Aid Standard

December 11, 1996

Mr. F****

Indianapolis, Indiana 

This letter is a follow-up to the conversation that a member of my staff had with Ms. Karol Copper-Boggs, of your firm, regardingthe Occupational Safety and Health Administration's (OSHA) interpretation of the First Aid standard, 29 CFR 1910.151.

Ms. Boggs explained to [my staff] that a client of your firm had some concerns regarding OSHA's interpretation of 29 CFR 1910.151. [The] recollection of the questions asked of [my staff] by Ms. Boggs is as follows:

Question 1: "Must an employer have individuals trained to render first aid?"

Answer: [No.] The OSHA requirement at 29 CFR 1910.151(b) states, "In the absence of an infirmary, clinic, or hospital in near proximity to the workplace which is used for the treatment of all injured employees, a person or persons shall be adequately trained to render first aid. [Adequate] [f]irst aid supplies approved by the consulting physician shall be readily available." [emphasis added]
[This document was edited on 8/19/1999 to strike information that no longer reflects OSHA policy.]

OSHA's regulation does not set specific response time requirements for the term "near proximity", however, in areas where accidents resulting in suffocation, severe bleeding, or other life-threatening or permanently disabling injury or illness are likely, a 3 to 4 minute response time, from time of injury to time of administering first aid, is required. In other circumstances, i.e., where a life-threatening or permanently disabling injury is an unlikely outcome of an accident, a longer response time, such as 15 minutes, is acceptable. The rationale for requiring a 4 minute response time is brain death when the heart or breathing has stopped for that period of time.
[This letter was edited on 6/12/2002 to strike information that no longer reflects current OSHA policy. Please see the
1/16/2007 letter to Mr. Brogan for the current policy.]

Question 2: "If an emergency situation were to occur where first aid was necessary and a trained employee were to panic, forgetting all of their training, and no first aid or improper first aid was administered could the employer be cited?"

Answer: If a trained employee were to panic in an emergency situation and not administer first aid or administer improper first aid, OSHA would not cite the employer. The employer would have met his obligation under the standard by having individuals trained to render first aid. The standard only requires employees to be trained in first aid, but does not address the actual performance of first aid in an emergency situation. Please note, however, that OSHA would conduct an investigation, if deemed necessary, to ensure that proper training certification, e.g., First Aid and CPR certificates were in order.

Question 3: "Would an employer be in violation of OSHA's First Aid standard if the employer were to issue a policy which recommends that employees call "911" in emergency situations?"

Answer: The purpose of first aid is to give injured employees some level of medical attention as quickly as possible to bridge the gap between the accident and full medical treatment. Therefore, the rendering of first aid should be encouraged by trained employees in addition to calling "911." Thus, an employer would not be in violation of OSHA's First Aid standard by issuing such a policy statement as long as the policy does not discourage the rendering of first aid by trained employees.

I hope this letter is responsive to your concerns. If we can be of further assistance please contact [the Office of General Industry Enforcement at (202) 693-1850].


Raymond E. Donnelly, Director
[Office of General Industry Enforcement]

[Corrected 05/31/2007]

November 19, 1996

Ms. Renee Carter
Directorate of Compliance
Occupational Safety and Health Administration
200 Constitution Ave. NW
Washington, D.C. 20210

Re: First Aid Training Statute 29 CFR 1910.151

Dear Ms. Carter:

Recently, Karla Cooper-Boggs of my office discussed with you the Occupational Safety and Health Administration's ("OSHA") interpretation of the first aid training statute, 29 CFR 1910.151. Outlined below is our understanding of that conversation.

You indicated that an employer must ensure that a number of its employees are trained in accordance with 29 CFR 1910.151, but that the employer is not required to ensure that the trained employee actually performs first aid. You stated that OSHA would not issue citations to the employer if its trained employee(s) rendered first aid improperly, or not at all.

It is also our understanding that an employer will not violate OSHA regulations by issuing a policy which recommends that employees call "911" in emergency situations, and that trained employees should attempt to administer first aid at their discretion so long as such a policy does not discourage the rendering of first aid by a trained employee.