MAINTAIN HYDRATION… MINIMIZE EXHAUSTION

…ensuring a healthier and safer working environment

GUIDELINES

Electrolyte Replacement Solution

 INTRODUCTION
If we consider the statistics for the past 30 years of weather related fatalities all over the world,
fatalities due the HEAT is the highest, followed by hurricane and flood.

Summer temperatures especially here in the Middle East can reach as high as 50 degrees
Celsius (122 degrees Fahrenheit), making heat related illness (such as heat exhaustion, heat
stress and heat stroke a very serious concern. Heat stroke can be fatal in many cases because it
happens so quickly - there is not much time to react. And not only that, to determine the actual
heat that a person feels, you need also to consider. The relative humidity - not just the tempera-
ture reading.

These are the reasons why Dubai Municipality have taken its own initiatives to increase aware-
ness and educated the employers and the workers about the serious consequences of heat
related illnesses thus the “Safe and Healthy Summer Campaign” was born.

The campaign material contains all the basic information about heat related illnesses - from
Employer or Management interventions, workers responsibilities as well as precautionary
measures to stay safe and healthy especially during summer.

SIGNS & SYMPTOMS OF HEAT RELATED ILLNESS

WARNING SIGNS
Heat VS heat
Exhaustion stroke
Heavy Sweating Extremely high body
Heat related illness is Paleness Temperature (>40°C)
PREVENT TABLE!
Plan your work. Muscle Cramps Red, hot, dry skin (with no
Drink plenty of water Tiredness sweating)
Avoid alcohol, soda, oily foods stop!
Wear light & comfortable Dizziness Rapid, Strong Pulse
If you have any of these
clothing Headache Dizziness symptoms - IT IS LIFE
Nausea/Vomiting Throbbing Headached THREATENING
Bring the person to
Fainting Nausea shaded/cool area and seek
Confusion medical attention
if left untreated, heat IMMEDIATELY.
exhaustion can lead to
HEAT STROKE

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 WHAT EMPLOYERS NEED TO DO
Employers should take the following precautions to protect workers from
heat stress:
1. Employers must conduct heat stress assessment, develop
and implement heat stress management program where a
worker is or may be exposed to conditions that could trigger
heat related disorders.
2. Employers must provide adequate training to all workers at
risk and it must contain at least the following:
• How heat stress and heat stroke develop
• How to prevent heat stress
• Importance of monitoring yourself and co-workers for symptoms
• Personal factors (e.g. weight, medical conditions, etc.)
• What to do if he or his co-worker develops heat illness at work
• Personal Protective Equipment (PPE)
3. Employers must implement engineering if not administrative control measures such as:
• Schedule work to minimize heat exposure (i.e. early morning or late afternoon for outside work)
• Establish work and rest cycles or practice job rotation
• Acclimatize workers by exposing them for progressively longer periods to hot work environments
4. Provide constant supply of cool drinking water & electrolyte replacement drink (hydration
liquids).
5. Ensure arrangement of welfare facilities e.g. shaded or well ventilated area for resting, access
to wash rooms, etc.
6. Ensure proper arrangement for first aid or medical assistance in case of emergency
7. Provide adequate supervision to all concerned workers. Do not allow workers to work alone
where heat stress is possible.

WHAT EMPLOYEES NEED TO KNOW

Workers should take precautions to avoid Heat Stress
1. Be physically fit - Acclimatize yourself gradually to heat exposure.
2. Stay Hydrated - Drink cool water frequently (e.g. 1 cup every 20
minutes) and electrolyte replacement drink (1 cup 2-3 times a day)
3. Avoid oily foods, heavy meals and drinks that contain alcohol or
drinks with much caffeine or sugar. Instead, consume more fruits &
vegetables.
4. Don't overexert or push yourself; if you’re getting tired, slow
down or work at a steady pace.
5. Take regular breaks in cool or shaded areas.
6. Monitor your physical condition and that of your workers.
7. Report any symptoms or cases of heat rash or stress to your superior or if you feel unwell on
the job.
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 SIGNS AND SYMPTOMS OF HEAT STRESS
High temperature combined with humidity leads to excessive sweating in an attempt to cool the body.
This can lead to rapid dehydration (excessive loss of body water & important electrolytes). This causes
various heat related illnesses and can lead to heat exhaustion and heat stroke if uncontrolled.
Huge sweat loss = Water + Electrolytes loss
Symptons of Dehydration in employees due to huge sweat loss.

AMBULANCE

Safety Problem (HSE Related)

Most Accidents happen due to
Human error on decision making and risk perception are primary
causes or contributors to serious accidents. Dehydration is one of
the important factors that affects the sense of body position
leading to accidents - Ref-USDA Forest Service Serious Accident Investigation
Guide (2005)

Even mild dehydration leads to deterioration in short-term

memory, simple visual orientation, simple arithmetic, and
complex motor coordination.

Risk of fall from Heights Impaired Physical Visual Disorientation

Performance

Confusion leads to ignore Discomfort Causes People to Heat Causes Poor

mer
Safety Procedures lose their temper Judgement

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 FACTORS AFFECTING HEAT STRESS RISKS
Factors that should be considered in assessing heat stress include:

1. ENVIRONMENTAL FACTORS - Environmental factors such as ambient air temperature, air

movement, and relative humidity can all affect an individual’s response to heat.

2. JOB FACTORS - Job factors may include the workload and the type of work of an individual as
well as the specific area or location of his work.

√ Workload - the body generates more heat during

heavy physical work such as construction workers
working in hot weather will generate a tremendous
amount of heat and are at risk of developing heat
stress without proper precautions.
√ Type of work – developing heat stress depends also
on the type of work being performed and which
specific area.
√ Clothing & Personal Protective Equipment (PPE) - heat stress can be caused or aggravated
by wearing PPE such as fire or chemical retardant clothing. Non breathable garments block
the evaporation of sweat and can lead to substantial heat stress. The more clothing worn or
the heavier the clothing, the longer it takes evaporation to cool the skin. Remember too that
darker-colored clothing absorbs more radiant heat than lighter-colored clothing.

3. PERSONAL RISK FACTORS - It is difficult to predict just who will be affected by heat stress and
when, because individual susceptibility varies. There are, however, certain physical conditions
that can reduce the body’s natural ability to withstand high temperatures such as:
√ Weight, age, etc.
√ Poor physical condition/ not physically fit
√ Previous or recent illness & medical condition
√ Heart disease/high blood pressure & medication
√ Lifestyle (alcohol consumption, lack of rest eating, etc)
√ Lack of acclimatization

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 PROPER HEAT STRESS MANAGEMENT CYCLE

Conduct
Heat Stress
Assessment

Supervise Develop and

and be implement
aware of the Heat Stress
symptoms. Program

Implement
Engineering
Maintain &
Hydration Administrative
Control
Measures

Schedule Acclimatize
Work & Rest the workers.
cycles

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 GOOD PRACTICES TO PREVENT HEAT STRESS
1. Hydration- Maintain hydration by drinking water and use of Electrolyte replacement drink for
quick Hydration.
2. Personal Hygiene - take showers before and after duty.
3. Healthy Eating – avoid oily/fatty foods, sodas - eat fruits & vegetables instead
4. Enough Rest – get enough rest and avoid alcohol, caffeine
5. Acclimatize – let your body gradually adjust to the heat
6. Urine check/chart – check your urine color for signs of dehydration
7. Clothing – Wear comfortable/loose, lightweight, light-colored clothing such as cotton.
8. Personal Protective Equipments – use hats, coveralls, sunscreens
9. Schedule work to minimize heat exposure. Do the hardest physical work during the coolest part
of the day (early morning or late afternoon)
10. Take rest breaks in a cool, shaded or well ventilated area. Take more breaks during the hottest
part of the day or when doing hard physical work. Allow your body to cool down before you
resume working again.
11. Learn to recognize the signs and symptoms of heat stress in yourself and of your co-workers.
Avoid working alone.
12. Always report to your superior if you feel unwell in the course of your duty.

CHOOSING THE RIGHT HYDRATION DRINKS

There are different hydrating drinks available- some are for treatment of dehydration (ORS - Oral
Rehydrate salts) and some for prevention of dehydration (Electrolyte Replacement drinks). Treatment
formula (ORS) contains high sodium and low carbohydrates and shall only be used under medical
supervision, Pls. check the guideline as follows and choose the right hydrating drink.
√ Right hydrating drinks (Electrolyte Replacement solution)
should contain all four well balanced electrolyte – more
potassium compare to sodium;

√ Carbohydrates should ideally be between 4% - 6%,

which helps faster fluid absorption and improve produc-
tivity. Below 4% absorption is slow and above 6% has a
diuretic effect (water loss is greater than the intake);

√ Palatable and tasty drinks encourage drinking, if it tastes

bad, workers feel nausea and avoid drinking. Most of the
well known sports /isotonic drinks have the same
formula/ingredients as above.
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 DAILY CHECKLIST
Check this guide before starting the work each day. √

Water - Is there plenty of cool drinking water and/or electrolyte replace-

and/or ment drink located as close as possible to the workers?
Hydration drink- - Are coolers refilled throughout the day.
Shade/ Welfare - Is there shade /welfare facilities available
Facilities for breaks and if workers need to recover?

Do workers know the:

- Common signs and symptoms of heat illness?
- Proper precautions to prevent heat illness?
Training - Importance of acclimatization?
- Importance of drinking water frequently (even when they are not
thirsty)?
- Steps to take in case of emergency?

- Does everyone know who to notify if there is an Emergency?

- Can workers explain their location if they need to call an
Emergencies
ambulance?
- Does everyone know who will provide first aid?
- Drink water (1 cup every 20 min.) and Hydration drink (1 cup,
2-3 times a day)
- Wear lightweight clothing made of breathable fabric
Worker
- Rest in the shade
Reminders - Watch yourself and your co-workers
- Report heat symptoms early
- Know what to do in an emergency

MONITOR YOUR HYDRATION THROUGH URINE CHART

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 UNDERSTANDING THE IMPORTANCE OF HEAT INDEX
WHAT IS HEAT INDEX?
The heat index (HI) is an index that combines air temperature and relative humidity in an attempt to
determine the human-perceived equivalent temperature – or how hot it feels to the person. The result
is also known as the "felt air temperature" or "apparent temperature".
For example, when the temperature is 32 °C (90 °F) with a humidity of 55%, the heat index or, the
heat index or the apparent heat that a person feel can be about 41 °C (106 °F).
So don’t just refer to your thermometer reading but consider the relative humidity as well to establish
your safe system at work procedures. Please refer to the chart below.

RELATIVE HUMIDITY (%)

25% 30% 35% 40% 45% 50% 55% 60% 65% 70% 75% 80% 85% 90% 95% 100%
42˚ 48 50 52 55 57 59 62 64 66 68 71 73 75 77 80 82
41˚ 46 48 51 53 55 57 59 61 64 66 68 70 72 74 76 49
TEMPERATURE (°C)

40˚ 45 47 49 43 53 55 57 59 61 63 65 67 69 71 73 75
39˚ 43 45 47 49 51 53 55 57 59 61 63 65 66 68 70 72
38˚ 42 44 45 47 49 51 53 55 56 58 60 62 64 66 67 69
37˚ 40 42 44 45 47 49 51 52 54 56 58 59 61 63 65 66
36˚ 39 40 42 44 45 47 49 50 52 54 55 57 59 60 62 63
35˚ 37 39 40 42 44 45 47 48 50 51 53 54 56 58 59 61
34˚ 36 37 39 40 42 43 45 46 48 49 51 52 54 55 57 58
33˚ 34 36 37 39 40 41 43 44 46 47 48 50 51 53 54 55
32˚ 33 34 36 37 38 40 41 42 44 45 46 48 49 50 52 53
31˚ 32 33 34 35 37 38 39 40 42 43 45 45 47 48 49 50
30˚ 30 32 33 34 35 36 37 39 40 41 43 43 45 46 47 48
29˚ 29 30 31 32 33 35 36 37 38 39 41 41 42 43 45 46
28˚ 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
27˚ 27 27 28 29 30 31 32 33 34 35 37 37 38 39 40 41
26˚ 26 26 27 28 29 30 31 32 33 34 35 35 36 37 38 39
25˚ 25 25 25 27 27 28 29 30 31 32 34 34 34 35 36 37
24˚ 24 24 24 25 26 27 28 28 29 30 32 32 33 33 34 35
23˚ 23 23 23 24 25 25 26 27 28 28 30 30 31 32 32 33
22˚ 22 22 22 22 23 24 25 25 26 27 28 28 29 30 30 31

Caution Extreme Caution Danger Extreme Danger

(32 below) (32 – 40) (41-53) (above 54)
Slight discomfort or Heat exhaustion Serious heat exhaustion Heat stroke or
fatigue possible. possible. Limit the likely to happen. Avoid if sunstroke or even
heaviest physical not stop all outdoor death likely to
activities. works. happen.

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 HEAT STRESS & SPORTS ACTIVITIES
Heat related illness does not occur only during work. Some
sports or other outdoor physical activities like exercise can
also be as dangerous. Heat stress occurs when sweat can't
evaporate fast enough to keep the body sufficiently cool.
When at rest and in comfortable temperatures, a person
sweats about two liters of fluid every 24 hours. During hot
weather (35°C), this fluid loss can leap to around 10 liters
over the same time period. Exercising in hot weather
accelerates fluid loss even more. Similar symptoms occur
like muscle cramps and headache and it often occur as a
result of excessive loss of body salts and water.
Suggestions to prevent heat stress during exercise include:
• Timing - start sporting activities before 9 am or after 6 pm during summer, and try to avoid
sport or exercise during the hottest part of the day.
• Rest breaks – frequent breaks is necessary and allow the body to cool down.
• Fluids – always maintain hydration. Drink at least half a liter of fluids within two hours
before exercising. During your sport, aim to drink about 200 ml every 20 minutes or so &
drink also after the activity.
• Hydration - weigh yourself before and after your game. A loss of one kilogram equals a
loss of one liter of fluids. If you find you have lost weight after your game, try to increase
your fluid intake next time.
• Fitness – a physically fit body is better able to manage the stresses of sport.
• Clothing – wear loose, light-colored and comfortable clothes made from natural fibers.
Wear a visor or hat.

CHILD SAFETY IN HOT WEATHER

Hot weather can be dangerous for babies and young children as well. Babies
and young children should be watched carefully during hot weather. They can
quickly lose body fluids through perspiration, which leads to dehydration. Here
are suggestions to take care of your children during hot weather:
1. Children, like adults , need to drink fluids regularly.
2. It is advisable that they wear light clothing to reflect sunlight instead
of dark colors that absorb heat.
3. Children are advised not to play in severe heat or air humidity – if
not, it should be an indoor place away from the sun and take
frequent breaks as well.
4. When in the beach, they should be protected with sunscreens
especially on the exposed part of the body.
5. Never leave a baby or child alone inside the car, even in cool weather. Even in mild weather, cars
quickly become too hot for small children.

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GUIDE TO HEALTHY FASTING DURING RAMADAN
1. Don’t break your fast with a feast or you may put on weight instead of losing it.
2. Observe balanced diet. Those observing the fast should have at least two meals a day – the pre-dawn
meal (suhoor) and a meal after dusk (iftar).
3. Avoid oily/fatty foods, deep fried foods and those that contain too much sugar.
4. Focus on healthy foods. Choose meals that keep you full longer during the day such as:
• Fiber: whole wheat grains, breads, cereals, brown rice, fruits & vegetables,
beans and unsalted nuts and seeds
• Protein: lean animal meat, fish/seafood, low fat or non-dairy milk, and unsalted nuts
and seeds
• Healthy fats: olives and olive oil, canola, avocadoes, fish oil
5. Hydrate frequently during non-fasting hours. Drinking excessive amount of fluids at ‘suhoor’ is not an
effective way to stay hydrated. Also avoid caffeinated and sugary drinks and beverages.
Avoid Smoking and get enough sleep and take naps if possible.
6. Break the fast gently. Traditionally, the daily fast during Ramadan is broken with dates and water.
7. Dates contain natural sugars that acts as an immediate source of energy for the body and it is also
rich in potassium – a mineral and electrolyte that helps maintain the body’s fluid balance.

HEAT STRESS PREVENTION

WATER
HYDRALYTE

‫ ﺍﻟﻣﺭﺍﻭﺡ‬/‫ﺗﻭﻓﻳﺭ ﺍﻟﺗﻬﻭﻳﺔ‬ ‫ﺧﺫﻗﺳﻁﺎ ﻣﻥ ﺍﻟﺭﺍﺣﺔ‬

‫ﺗﻭﻓﻳﺭ ﺃﻣﺎﻛﻥ ﻣﻅﻠﻠﺔ ﻟﻠﻌﻣﻝ ﻛﻠﻣﺎ ﺃﻣﻛﻥ‬ (‫ ﺩﺭﺟﺔ ﻣﺄﻭﻳﺔ‬۳۷‫)ﻳﺟﺏ ﺍﻥ ﺗﻛﻭﻥ ﺩﺭ ﺟﺔ ﺍﻟﺣﺭﺍﺭﺓ ﺩﻭﻥ ﺍﻝ‬ ‫ﺃﻗﻠﻡ ﻧﻔﺳﻙ‬ ‫ﺣﺎﻓﻅ ﻋﻠﻰ ﺳﻭﺍﺋﻝ ﺟﺳﻣﻙ‬
Provide Ventilation / Fan Drink water ‫ﻓﻲ ﻣﻧﺗﺻﻑ ﺍﻟﻳﻭﻡ‬
Provide shaded area for work (The temperature should be Acclimatize yourself
as much as possible. below 37 degrees Celcium) & Hydralyte Mid Day Break

odium
High S ns
Solutio

،‫ﺗﻧﺎﻭﻝ ﺍﻟﻐﺫﺍء ﺍﻟﺻﺣﻳﺢ‬ ‫ ﺍﻟﻛﻭﻻ‬،‫ ﺍﻟﻘﻬﻭﺓ‬،‫ﺗﺟﻧﺏ ﺗﻧﺎﻭﻝ ﺍﻟﺷﺎﻱ‬ ‫ﺗﺟﻧﺏ ﺗﻧﺎﻭﻝ ﺃﻗﺭﺍﺹ ﺍﻟﻣﻠﺣﻭﺍﻟﻣﺣﺎﻟﻳﻝ ﺍﻟﺗﻲ‬ ‫ﺟﺩﻭﻟﺔ ﺍﻷ ﻋﻣﺎﻝ ﺍﻟﺷﺎﻗﺔ‬
‫ﺍﻟﺻﺣﻲ ﻭﺍﻟﺧﻔﻳﻑ‬ ‫ﺗﺣﺗﻭﻱ ﻋﻠﻰ ﻧﺳﺑﺔ ﻋﺎﻟﻳﺔ ﻣﻥ ﺍﻟﺻﻭﺩﻳﻭﻡ‬ ‫ﻟﻠﺻﺑﺎﺡ ﺍﻟﺑﺎﻛﺭ ﺃﺭ ﺃﻭ ﻓﺗﺭﺓ ﺍﻟﻣﺳﺎء‬
Avoid Tea, Avoid Salt Tablets & Heavy work Schedule
Eat Right Eat Light Coffee & Cola Drink High Sodium Solutions (ORS) Early morning or late afternoon
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