May, 2011
Feature
Inspection News and Views from the American Society of Home Inspectors



When HOT Goes Way Beyond Uncomfortable

SANDY BOURSEAU

From ironworkers to pastry bakers, NIOSH (National Institute for Occupational Safety and Health) recognizes workers are at risk from  being exposed to high temperatures  and humidity. It's a long list, but nowhere on it will you find home inspectors.

As is with so many other work-related hazards, home inspectors are expected to learn on their own how to recognize and avoid the risks to their health and safety from extreme heat.

Sometimes they learn the hard way. Kenny Hart, Virginia Beach, Va., described an incident he said increased his awareness and may have affected his tolerance for heat. As regular readers know, Hart's past life included working as a plumber. He said he was digging up a septic tank located next to a house, working in the blazing sun.

"I was lying on my stomach, looking into the tank, when I realized things were getting blurry. As the sweat dripped off my nose, it dawned on me I was alone, and I needed water. When I stood up, turned around and reached for the house, I saw stars. I used the side of the house to stumble to a nearby open door. Inside, I leaned over the kitchen sink, ran cool water over my arms, occasionally splashing my face. I tried to sip the water, but was sick in my stomach. When I moved toward the bathroom, I got dizzy again, collapsed on the bathroom floor, but never lost consciousness. Eventually, I was able to get to my knees and run more water over my arms and wipe my face with a wet rag. I spent the rest of that day drinking Gatorade and resting."

Commenting on extreme heat as it relates to inspecting homes, he said, "This experience changed the way I deal with heat. If I get overheated doing something as simple as walking around the outside of a house, I go to my truck and suck up some air conditioning until I cool down.

"I don't know of too many inspectors who will not hit the attic because of the heat but, no doubt, heat speeds up the time we spend there."

Hart's symptoms are common to the three conditions that can result from the body overheating: heat cramps, heat exhaustion and heat stroke.

Heat cramps


Heavy sweating drains the body of salt, which cannot be replaced simply by drinking water. Painful cramps occur in the arms, legs or stomach while experiencing extreme heat or later. Moving to a cool area when cramping is experienced, loosening clothing and drinking cool, lightly-salted water or a commercial fluid-replacement beverage can help. Seek medical aid if the cramps are severe or don't go away.

Heat Exhaustion


Heat exhaustion may resemble the early symptoms of heat stroke. It is caused by the loss of large amounts of fluid by sweating, sometimes with excessive loss of salt. A person suffering from heat exhaustion still sweats, but experiences extreme weakness or fatigue, giddiness, nausea or headache. In more serious cases, the victim may vomit or lose consciousness. The skin is clammy and moist, the complexion is pale or flushed, and the body temperature is normal or only slightly elevated.

Victims with mild cases may recover by resting in a cool place and drinking plenty of liquids. Symptoms are the same for severe cases, with the addition of body temperature over 38 C degrees, weak pulse and normal or low blood pressure. The person will be very thirsty, and will pant or breathe rapidly. Vision may be blurred. A more aggressive response is recommended. Specifically: Get medical help immediately! Heat exhaustion can lead to heat stroke, which can kill. Move the person to a cool, shaded area. Loosen or remove excess clothing. Provide cool, lightly salted water. Fan and spray the victim with cool water. Those with severe cases may require extended care for several days. There are no known permanent effects.

Heatstroke

Heatstroke is the most severe of the heat-related problems, often resulting from exercise or heavy work in hot environments, combined with inadequate fluid intake.
Young children, older adults, people who are obese and people born with an impaired ability to sweat are at high risk of heatstroke. Other risk factors include dehydration, alcohol use, cardiovascular disease and certain medications.

What makes heatstroke severe and potentially life-threatening is that the body's normal mechanisms for dealing with heat stress, such as sweating and temperature control, are inadequate. The main sign of heatstroke is a markedly elevated body temperature — generally greater than 104 F (40 C) — with changes in mental status ranging from personality changes to confusion and coma. Skin may be hot and dry — although if heatstroke is caused by exertion, the skin may be moist.

Other signs and symptoms may include:

  • Rapid heartbeat
  • Rapid and shallow breathing
  • Elevated or lowered blood pressure
  • Cessation of sweating
  • Irritability, confusion or unconsciousness
  • Feeling dizzy or lightheaded
  • Headache
  • Nausea
  • Fainting, which may be the first sign in older adults

If you suspect heatstroke:

  • Move the person out of the sun and into a shady or air-conditioned space.
  • Call 911 or emergency medical help.
  • Cool the person by covering him or her with damp sheets or by spraying with cool water. Direct air onto the person with a fan or newspaper.
  • Have the person drink cool water or other nonalcoholic beverage without caffeine, if he or she is able.44

Early recognition and treatment of heat stroke are the only means of preventing permanent brain damage or death.

Staying safe where extreme heat is commonplace

It's called the Sun Belt with good reason. ASHI members who live and work in the southern tier of the United States enjoy mild, brief winters and extended summers. Inspecting homes does not allow them to take full advantage of the availably of air conditioning that helped fuel population growth across this region.

Past-president Mark Cramer, Indian Rocks Beach, Fla., said, "Heat is more than uncomfortable; it can pose a risk to the health and safety of a home inspector."

He said, "Working in Florida in the summertime is difficult. Even standing outside when it's 92 degrees and 85 percent humidity is taxing. In the summer, I alter my normal work habits and work outside a bit, then go inside to cool off for a while, trying to maintain a reasonable body temperature and dry clothing.

"Attic temperatures here in the summer are usually at least 105 degrees, and sometimes as much as 130 degrees. I have to limit the time I spend in an attic. When temperatures in the attic are 120 or higher, I won't go very far from the access opening. At those temperatures, with physical exertion, you are subject to hyperthermia. I try to stay in the attic no more than five minutes or so. In some cases, it requires multiple trips to complete the inspection of the attic. I know of more than one inspector who has passed out in a hot Florida attic.

"I have a cooling vest I'll sometimes use, but it's a bit of a pain. It has ice packs built into it. You freeze it before use. It helps for about half an hour or so. Another trick I'll use is putting my crawl suit, respirator, gloves and kneepads in the freezer before I put them on. I'll usually put a couple of ice cubes in the respirator to help keep me cool. This only helps for about 10 minutes, but it's better than nothing!

"I also carry a box fan around in the summer. I'll set that up in the garage and use it while inspecting that area. Sometimes, I'll drag it up into the attic and set it near the opening. Anything helps!"

 ACI Bruce Barker, Peoria, Ariz., realizes the dangers of working in extreme heat, and he shared how he manages the risks of working in a desert climate.

Desert rule 1: Stay hydrated.

Corollary 1: Don't leave home without water.

This is one of the first lessons one learns in a desert city like Phoenix, and this is a good lesson in any hot climate.

Hyperthermia, elevated body temperature, is a serious condition that, left untreated, can be fatal. People like home inspectors who work in hot places like attics are particularly susceptible to hyperthermia. Older inspectors and inspectors who are overweight are even more susceptible.

"I try to avoid afternoon inspections from about mid-June through August, but most inspectors don't have that luxury. If I must do an afternoon inspection in the summer, I warn clients that my attic inspection may be limited, and I include a statement to that effect in my report.

"I apply plenty of SPF50 or better sunscreen on all exposed skin, including the bald spot on my head. I also wear a hat. Melanoma is a substantial risk in Phoenix where the sun is intense and there rarely are any clouds. Not that clouds matter that much. UV radiation can penetrate clouds."

Away from the South: Transient heat fatigue

Throughout the Midwest, even as far north as Minnesota, summer temperatures can reach extreme levels. People who are unaccustomed to the heat are particularly susceptible to transient heat fatigue, a temporary state of discomfort and mental or psychological strain arising from prolonged heat exposure. They may suffer, to varying degrees, a decline in task performance, coordination, alertness and vigilance. The severity can be lessened by a period of gradual adjustment to the hot environment.

ACI Roger Hankey, Eden Prairie, Minn., shared tips for working in the heat of a northern summer, including a few not mentioned previously, that are worth remembering wherever you work.

He said, "Bring a water bottle and drink before you are thirsty. There are still many vacant foreclosed homes in the northland that remain winterized (water service disconnected) during the summer. Even though we ask agents to arrange for all utilities to be on, we can encounter disconnected utilities (therefore, no water or air conditioning on site).

"Roof surfaces are HOT. Gloves and kneepads are important pieces of personal protective gear. Follow standard safe practices on the roof, such as:

• Do NOT walk backwards, and

• Do NOT walk while inspecting (walk - stop - inspect - then walk to new location, look where you are walking).

"Plan your attic examination based on the time of day. For morning inspections, do the attic first. Afternoon attic inspections may depend on the extent of cloud cover, a rain shower or shading of the roof. Just think about when the attic will be cooler. Also, open the hatch and wait a few minutes for the additional ventilation provided by airflow up through the hatch. Opening a window on a lower level may increase the ventilation rate via convective airflow through the hatch."

Preparing for the heat

Humans are, to a large extent, capable of adjusting to the heat. This adjustment to heat, under normal circumstances, usually takes about five to seven days, during which time the body will undergo a series of changes that will make continued exposure to heat more endurable.

On the first day of work in a hot environment, the body temperature, pulse rate, and general discomfort will be higher. With each succeeding daily exposure, all of these responses will gradually decrease, while the sweat rate will increase. When the body becomes acclimated to the heat, you will find it possible to perform work with less strain and distress.

Number and duration of exposures

Rather than be exposed to heat for extended periods of time during the course of a job, work-rest cycles should occur evenly over the day. Work-rest cycles give the body an opportunity to get rid of excess heat, slow down the production of internal body heat and provide greater blood flow to the skin.

A hot spell or a rise in humidity can create overly stressful conditions. The following practices can help reduce heat stress:

Rest
Resting in a cool environment considerably reduces the stress of working in the heat. There is no conclusive information available on the ideal temperature for a rest area. However, a rest area with a temperature near 76 F appears to be adequate. As Hart mentioned, he returns to his air-conditioned truck when he feels overheated. Shorter, but frequent, work-rest cycles are of the greatest benefit.

Drinking water
As Roger Hankey mentioned, drink before you're thirsty. In the course of a day's work in the heat, you may produce as much as two to three gallons of sweat. Because so many heat disorders involve excessive dehydration of the body, it is essential that water intake during the workday be about equal to the amount of sweat produced. Most workers exposed to hot conditions drink fewer fluids than needed because of an insufficient thirst drive. Drinking five to seven ounces of fluids every 15 to 20 minutes will replenish the necessary fluids in the body.

Heat-acclimatized workers lose much less salt in their sweat than do workers who are not adjusted to the heat. The average American diet contains sufficient salt for acclimatized workers even when sweat production is high. If, for some reason, salt replacement is required, the best way to compensate for the loss is to add a little extra salt to the food. Salt tablets are not recommended.

Protective Clothing
Mark Cramer described the protective clothing he uses. Clothing inhibits the transfer of heat between the body and the surrounding environment. Therefore, in hot jobs where the air temperature is lower than skin temperature, wearing clothing reduces the body's ability to lose heat into the air.

When air temperature is higher than skin temperature, clothing helps to prevent the transfer of heat from the air to the body. However, this advantage may be nullified if the clothes interfere with the evaporation of sweat.

Special considerations during prolonged heat spells


During unusually hot weather conditions lasting longer than two days, the number of heat illnesses usually increases. This is due to several factors, such as progressive body fluid deficit, loss of appetite (and possible salt deficit), buildup of heat in living and work areas, and breakdown of air-conditioning equipment. Therefore, it is advisable to make a special effort to adhere rigorously to preventive measures during extended hot spells.

As recommended by Bruce Barker, inspecting attics should be performed during the cooler parts of the day.

Being uncomfortable is not the major problem with working in high temperatures and humidities. Heat can kill.

Awareness is importan
t

The key to preventing excessive heat stress is knowing the hazards of working in heat and the benefits of work practices. Most home inspectors set limits on the height and slope of roofs they will walk. There should be similar limits for working in extreme heat environments.

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Heat Promotes Accidents

Certain safety problems are common to hot environments. Heat tends to promote accidents due to the slipperiness of sweaty palms, dizziness, or the fogging of safety glasses. Wherever there exists hot surfaces, steam, etc., the possibility of burns from accidental contact also exists.

Aside from these obvious dangers, the frequency of accidents in general appears to be higher in hot environments than in more moderate environmental conditions. One reason is that working in a hot environment lowers the mental alertness and physical performance of an individual. Increased body temperature and physical discomfort promote irritability, anger and other emotional states, which sometimes cause people to overlook safety procedures or to divert attention from hazardous tasks.

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Note: The consumption of alcoholic beverages during prolonged periods of heat can cause additional dehydration. Persons taking certain medications (e.g., medications for blood pressure control, diuretics or water pills) should consult their physicians in order to determine if any side effects could occur during excessive heat exposure. Daily fluid intake must be sufficient to prevent significant weight loss during the workday and over the workweek.

Sources include: NCEH's Health Studies Branch, NIOSH, Mayo Clinic, CDC.