Outdoor Hazards: They're Out to Get You!

Employees must be trained on multiple hazards, from weather emergencies to insects, plants, sunburn, and heat-related illnesses.

• By Robert A. Ernst
• May 01, 2003

WE all enjoy being outside when the weather is pleasant. And after a long winter, warming temperatures and sunny conditions lure our employees out of doors for work-related tasks, at-home yard work, or just for recreation. This creates some unique problems for those responsible for safeguarding the health and safety of workers.

Many occupations require employees to be outdoors for at least part of the time. OSHA requires that employees be trained to recognize and avoid all workplace hazards, including those that can occur outside. It also makes sense to train employees on how to avoid outdoor hazards off the job so they stay safe and healthy while away from work.

Most of us know that when we are outdoors, exposure to the mix of heat, humidity, and sun can lead to serious heat-related illnesses. But a number of other problems can occur from sunburns to insect bites and stings. They include:

• Natural or man-made terrain hazards on the job site,
• Dermatitis from poisonous plants,
• Severe weather conditions,
• Sunburn, heat stress, heat exhaustion, or heat stroke, and
• West Nile virus, Lyme disease, and other insect-borne diseases.

The Lay of the Land
The work site, as well as the layout of the area around it, can contribute to hazardous conditions when working on the grounds or just walking to a job site.

• Uneven surfaces, wet grass, and mud can make for dangerous travel, whether walking or driving. Take precautions when maneuvering vehicles over rough terrain.
• Holes in the ground can cause trips or falls. Make sure they are identified and marked, or filled in quickly.
• Certain terrain hazards can cause water to collect. Water can create a drowning hazard; according to OSHA, excavations must be inspected after every rainstorm.
• Hazards can also be found overhead. Remember to keep track of where any power lines might be when working or moving equipment.

Leaflets Three, Let it Be!
Poison ivy is the name commonly applied to several different species of the sumac family that include poison ivy, poison oak, and poison sumac. Each year, these plants cause almost two million cases of dermatitis. Knowing how to identify these plants will help your employees avoid contact with them.

The folk wisdom "Leaflets three, let it be" is a good rule for employees assigned to work near any vegetation. All the plants mentioned except poison sumac have three-leaflet stems. The two side or lateral leaflets appear to be symmetrical and grow close to the stem, while the end leaflet is distinct and alone. When you see this configuration, watch out!

Poison sumac can have seven, nine, or more leaflets growing in symmetrical pairs close to the stem--except for the one at the end. The odd numbers of leaves, the symmetrical pairing, and the isolated end leaflet should allow employees to be able to identify poison sumac.

• Teach employees to identify these plants to avoid contact with them. Trousers tied at the leg, a long-sleeved shirt, and gauntlet-type gloves will help protect against direct contact.
• Touching contaminated clothing or breathing smoke from burning leaves can have the same effect as direct contact. Clothing and tools can remain contaminated for years. Take precautions to prevent indirect contamination.
• Barrier cream can help protect bare skin from contact. Use barrier cream every day before beginning work and again after washing your hands.

Severe Weather
Some areas of the country are more susceptible to certain types of severe weather than others. Train your employees on the types of severe weather that occur in your location. Weather hazards include:

• Lightning and thunderstorms,
• Flooding and flash flooding,
• Strong winds, tornadoes, and hurricanes, and
• Snow, freezing rain, sleet, and hail.

Develop emergency action plans for all likely severe weather scenarios, and train workers how to respond to the various threats. Designate appropriate shelter sites, and monitor local weather warning systems. Demonstrate how weather alarms will be given, and hold drills so that employees may practice appropriate responses, ask questions, and generally prepare for emergencies.

Lightning
Lightning strikes happen throughout the year and can hurt or kill those hit, as well as cause damage to facilities and equipment. Lightning poses a danger even when several miles away It can strike almost anywhere and any time, even from a cloudless sky, and up to 10 miles away from the source.

Tornadoes
Tornadoes can occur at any time of the year. However, they usually occur between the hours of 3 p.m. and 9 p.m. If a tornado threatens:

• Do not open windows--opening the window does nothing to protect the building and may lead to injury due to broken glass.
• Go to pre-designated tornado shelter areas.
• If outside and unable to find shelter, lie down in a ditch, ravine, or culvert and cover your head with your arms. Watch for flash flooding.

Hurricanes
Hurricane "season" typically runs from June to November, but hurricanes can occur before and after the season. A hurricane watch means hurricane conditions are forecast for 24 to 36 hours. A hurricane warning means hurricane conditions are expected within 24 hours.

Sunburn and Heat Illnesses
While we might enjoy working outside in the sun, too much sun exposure can lead to sunburn and other skin problems. Sunburns can be harmful and, in certain cases, can result in a recordable injury.

Employers are required to protect employees against overexposure to the sun's radiation. With the potential for sunburn, a shirt would be considered personal protective equipment just the same as goggles, hard hats, or respirators. Employers can be cited for failure to enforce the use of personal protective equipment including shirts as protection against sunburn injuries.

Some recommendations OSHA has provided for protection from the sun include:

• Wear clothing that does not transmit visible light. If an employee can see his/her hand through the fabric, the garment offers little protection against sun exposure.
• Wear a wide-brim hat to protect the neck, ears, eyes, forehead, nose, and scalp. A hard hat with a 360-degree brim is effective.
• Use a sunscreen with a sun protection factor (SPF) of 15 or higher to block out at least 93 percent of the UV rays. Sunscreen should be applied at least 15 minutes before going outdoors and reapplied every two hours. OSHA states that sunscreen must be used in situations where it is the only effective means of protection.
• Wear sunglasses that block UV rays.
• Limit direct sun exposure and seek shade whenever possible.

• Employees become more vulnerable to heat-related injuries and illnesses with rising summer temperatures. Personal characteristics such as age, weight, fitness, and medical condition can affect an employee's ability to deal with excessive heat.

Heat rash
Also known as prickly heat, heat rash may occur in hot and humid environments where sweat is not easily removed from the surface of the skin by evaporation. Often, it occurs in areas where clothing presses or rubs against the skin. Heat rash is not just a nuisance, but also interferes with the body's ability to sweat, reducing the ability of the body to handle heat.

Heat cramps
Heat cramps are painful muscle spasms caused by heat, dehydration, poor conditioning, and the body's salt loss. Tired muscles--those used for performing the work--are usually the ones most susceptible to cramps.

Heat exhaustion
Heat exhaustion results from loss of fluid through sweating when a worker has failed to drink enough fluids. If heat exhaustion is not treated, the illness may advance to heat stroke. Symptoms include:

• Paleness
• Dizziness
• Weakness
• Muscle cramps
• Nausea
• Vomiting
• Headache, and
• Pale, clammy skin

Heat stroke
Heat stroke is caused by the body's failure to regulate its core temperature. Sweating stops and the body can no longer rid itself of excess heat. Unless treated promptly, victims of heat stroke will die. Symptoms include:

• Dry, pale skin (no sweating)
• Hot, red skin (looks like a sunburn)
• Mood changes (irritable or confused)
• Seizures
• Headaches
• Rapid pulse, and
• Unconsciousness

To prevent heat-related illnesses, train your employees on the following:

• Drink cool water in small amounts frequently--one cup every 20 minutes. Avoid alcohol, coffee, tea, and caffeinated soft drinks, which cause dehydration.
• Wear lightweight, light-colored, loose-fitting clothing and change clothing if it gets completely saturated. Use sunscreen and wear a hat when working outdoors.
• Use short, frequent work-rest cycles when it's hot. Alternate work and rest periods with longer rest periods in a cooler area, and schedule heavy work for cooler parts of the day.
• Realize that certain medical conditions, such as heart conditions and diabetes, and some medications can increase the risk of injury from heat exposure.

• Other steps employers can take to prevent heat-related illnesses include:
• Have good general ventilation, as well as spot cooling, in work areas of high heat production. Good air flow increases evaporation of sweat, which cools the skin.
• Monitor workplace temperature and humidity and be alert to early signs of heat-related illness. Allow employees to take a rest break if they become extremely uncomfortable.
• Ensure first aid responders can recognize and treat the signs of heat stress, heat exhaustion, heat cramps, and other heat-related illnesses.
• Use common sense when determining fitness for work in hot environments. Lack of acclimatization, age, obesity, poor conditioning, pregnancy, inadequate rest, previous heat injuries, medical conditions and medications are some factors that increase susceptibility to heat stress.

Insects
Summer insects can be more than annoying; bites and stings can lead to serious illnesses. In addition to the pain and swelling from insect stings, in some people stings can cause life-threatening allergic reactions. Or victims may be infected with more serious diseases or bacteria.

Hornets and bees
Hornets, wasps, and yellow jackets can sting repeatedly. Bees sting only once but leave behind a barbed stinger and poison sac that keeps pumping venom. This must be removed as quickly as possible.

Watch sting victims for prominent swelling and tenderness in the area of the stings. Look for hives to develop or any problem breathing or swallowing. Seek medical attention for these problems or for stings occurring near the eyes, nose, or throat. Employees can avoid some insect-related problems by:

• Not wearing sweet-smelling perfumes, hairsprays, and deodorants.
• Not wearing brightly colored clothing or clothes with flowery patterns.
• Not eating in areas where there are bees or hornets, because they are naturally attracted to food odors.
• Not panicking if they find a hive or nest. Stop and back away slowly, unless they begin to sting--then run!

Lyme disease . . . just the facts
Lyme disease has quickly spread to nearly all parts of the country. Your state and local health department can confirm its presence in your area. The level of risk can vary from year to year, based upon environmental factors.

Lyme disease is caused by Borrelia burgdorferi, a bacterium carried by the nymph stage of the deer tick. Most people infected with Lyme disease develop a rash; however, 20 to 40 percent of those who have the disease do not develop the rash. Other symptoms may be non-specific and similar to flu symptoms (e.g., fever, lymph node swelling, neck stiffness, generalized fatigue, headaches, migrating joint aches, or muscle aches).

Antibiotics successfully treat most cases of Lyme disease. If left untreated, Lyme disease may result in symptoms that are severe, chronic, and disabling, such as arthritis, muscle pain, and heart disease, as well as brain and nerve disorders.

Decrease the probability of tick bites by:

• Avoiding tick habitat (brushy, overgrown, and woody areas), particularly in spring and early summer when young ticks feed.
• Removing leaves, tall grass, and brush from areas around work areas to decrease habitat.
• Applying tick-toxic chemicals to surrounding work areas in accordance with federal, state, and local regulations and community standards.
• Wearing light-colored, long-sleeved shirts, tucking pant legs into socks or boots.
• Wearing high boots or closed shoes covering the entire foot.
• Wearing a hat.
• Using appropriate insect repellents.
• Showering and washing clothes after outdoor exposure.

• After working in tick infested areas, do a careful body check for ticks, promptly remove them with tweezers, and cleanse the skin with antiseptic.

Encephalitis
Several forms of mosquito-borne encephalitis can be transmitted by infected mosquitoes. Outbreaks of Eastern equine, La Crosse, and St. Louis encephalitis have occurred at various times, and these diseases can be deadly. Encephalitis-carrying mosquitoes are most active at dusk and at night.

West Nile virus
Most West Nile virus infections cause either no symptoms or a mild, flu-like illness. Persons over age 50 are at higher risk of severe illness. For the most part, normally healthy people will not be affected, or if they do contract it, any symptoms will be mild. And the chances of contracting the virus through mosquito bites are very slim.

Protective actions include:

• When possible, schedule work to avoid having workers outdoors when mosquitoes are most active and biting--at dawn, dusk, and in the early evening.
• Eliminate as many sources of standing water as possible to reduce mosquito breeding areas. Turn over, cover, or remove tarps, buckets, barrels, and wheelbarrows that accumulate water.
• Wear long-sleeved shirts, long pants, and socks.
• Spray exposed skin with insect repellents. Use DEET (N-N-diethyl-3-methylbenzamide or N,N-diethylmetatoluamide) at concentrations of 35 percent or less.

If providing insect repellents or insecticides, make sure that the employees read, understand, and follow the manufacturer's recommendations, as printed on the container label. Provide training on the most effective use, and explain how employees should handle personal hygiene and contaminated clothing after use. It is particularly important to provide more help to those employees without adequate reading skills, or who may not speak English.

Because mosquitoes breed in any puddle or water that stands for more than four days, workers at sites near ponds, irrigation ditches, or other stagnant water may be at increased risk of mosquito exposure.

Protect Yourself Against Sunlight
Skin cancers are rapidly increasing in the United States. Melanoma, the most serious skin cancer, accounts for more than 75 percent of skin cancer deaths. Sunlight is the main source of ultraviolet (UV) radiation known to damage the skin. In addition, sun exposure can cause cataracts and other eye problems. To protect yourself:

• Cover up. Wear clothing that protects as much of your skin as possible. Remember that very light, thin, or worn fabric may not offer much protection.
• Use sunscreen with an SPF of 15 or higher. An SPF 15 blocks 93 percent of the burning UV rays. Apply sunscreen liberally at least 15 minutes before going outside. Reapply every two hours, or more frequently if you sweat a lot.
• Wear a hat. A wide brim hat protects the neck, ears, eyes, forehead, nose, and scalp. A baseball cap provides some protection for the front and top of the head but not for the back of the neck or the ears, where skin cancers commonly develop.
• Wear sunglasses to protect your eyes. Sunglasses should block 99 to 100 percent of UV radiation. Check the label to make sure they do. Darker glasses do not necessarily provide protection. UV protection comes from an invisible chemical applied to the lenses, not from the color or darkness of the lenses.
• Limit direct sun exposure. The most intense UV rays occur during the high mid-day sun, between 10 a.m. and 4 p.m. Work in the shade whenever possible.

The most important warning sign for skin cancer is a spot on the skin that changes in size, shape, or color over a period of one month to two years. The most common skin cancers often appear as:

• A pale, wax-like, pearly nodule;
• A red scaly, sharply outlined patch; or
• A sore that does not heal.

Melanoma often starts as a small, mole-like growth. See a health care clinician if you find an unusual skin change. Skin cancers can almost always be cured when detected early.

This article originally appeared in the May 2003 issue of Occupational Health & Safety.