EHS Administration, Heat illness

Preventing Heat-Related Injuries

With the Occupational Safety and Health Administration’s (OSHA) National Emphasis Program (NEP) on Outdoor and Indoor Related Hazards being effective as of April 8, 2022, employers are advised to take note of the program’s instructions to avoid “largely preventable” heat-related illnesses.

“Despite widespread under-reporting, 43 workers died from heat illness in 2019, and at least 2,410 others suffered serious injuries and illnesses,” states an OSHA news release on the enforcement initiative. “The Atlantic Council’s Adrienne Arsht-Rockefeller Foundation Resilience Center estimates the economic loss from heat to be at least $100 billion annually – a number that could double by 2030 and quintuple by 2050 under a higher emissions scenario.”

One new resource for employers is, a new website launched July 26 by the Biden administration to provide the public and decision-makers with clear, timely, and science-based information to understand and reduce the health risks of extreme heat. offers maps, data, and information from both inside and outside of government that will enable informed daily decisions and allow planning weeks and months ahead. The site features heat information from across federal agencies, including heat forecasts from the National Oceanic and Atmospheric Administration’s (NOAA) National Weather Service; the new national Climate and Health Outlook, developed by the Department of Health and Human Services; the Centers for Disease Control and Prevention’s (CDC) Heat and Health Tracker; and heat planning and preparedness guides. also includes information on interagency National Integrated Heat Health Information System (NIHHIS) programs; events and news articles; heat and health program funding opportunities; and information to help at-risk communities.

The website is a priority of the National Climate Task Force and its Interagency Working Group on Extreme Heat, according to a NOAA news release.

NEP directive

The OSHA initiative applies to indoor and outdoor worksites in general industry, construction, agriculture, and maritime where potential heat-related hazards exist. On days when a recognized heat temperature can result in increased risks of heat-related illnesses, OSHA will increase enforcement efforts.

As summarized by the Society for Human Resource Management (SHRM), employers are encouraged to proactively implement intervention methods on heat priority days, including:

  • “Develop a written heat illness prevention plan.
  • Provide training to managers and workers on the signs and symptoms of heat illness.
  • Ensure acclimatization.
  • Provide water.
  • Require rest breaks.
  • Provide shade and cool rest areas.
  • Monitor workers wearing face coverings.
  • Implement a buddy system.”

The OSHA initiative prioritizes heat-related interventions and inspections of work activities on days when the heat index exceeds 80 degrees Fahrenheit.

Although OSHA published an advance notice of proposed rulemaking for heat injury and illness protection in indoor and outdoor work settings, a final rule has not yet been issued.

To further avoid heat-related illnesses, OSHA advises employers to acclimate workers to performing strenuous work when the heat index reaches 80 degrees Fahrenheit or higher.

SHRM recommends the following acclimatization activities for new workers or those who have not been regularly working in the heat:

  • Schedule new workers to work shorter amounts of time in the heat, separated by breaks, in heat stress conditions.
  • Ensure new workers only work 20 percent in the heat of the normal duration on their first day in the heat (20 percent first day).
  • Increase work duration in the heat by 20 percent on subsequent days until the worker is performing a normal schedule in the heat (20 percent each additional day).
  • Understand that some workers may need up to 2 weeks to acclimatize.
  • Workers should do the same task during the acclimatization week that they will do during a full schedule in the heat.
  • Give new workers more frequent rest breaks—at least one rest break during the period when they are working in the heat.
  • Train new workers on heat stress, symptoms of heat-related illness, and the importance of rest and water.
  • Monitor new workers closely for any symptoms of heat-related illness.
  • Use a buddy system, and don’t allow new workers to work alone.
  • If new workers talk about or show any symptoms, (1) allow them to stop working, (2) initiate first aid, and (3) never leave someone alone who is experiencing symptoms.

OSHA inspections

During OSHA heat-related inspections, compliance safety and health officers (CSHOs) will take the following actions:

  1. Review OSHA 300 logs and 301 Incident Reports for any entries indicating heat-related illness(es).
  2. Review any records of heat-related emergency room visits and/or ambulance transport, even if hospitalizations did not occur. (This may require the use of a Medical Access Order.)
  3. Interview workers for symptoms of headache, dizziness, fainting, dehydration, or other conditions that may indicate heat-related illnesses, including both new employees and any employees who have recently returned to work.
  4. Determine if the employer has a heat illness and injury program addressing heat exposure.
  5. Document conditions relevant to heat-related hazards.
  6. Identify activities relevant to heat-related hazards.

For more information on the OSHA NEP focused on heat, employers are advised to carefully review the published Agency Instruction.

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