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Heat Stress and Heat Induced Illnesses

By Jason Jantzi, Risk Management Consultant - Fire | jjantzi@sdao.com 503-599-0389 or 800-285-5461

On Monday, June 28, 2021, I was notified of a young firefighter who was hospitalized with potential renal damage and was diagnosed with rhabdomyolysis (rhabdo).  I felt it would be wise to revisit this article from 2020 related to rhabdo.  This is a serious illness that has hospitalized several workers including multiple firefighters in the past couple years.  With the temperatures high and the workload high, this is an important concern to discuss.  A common theme with these serious illnesses has been the use of workout supplements and energy drinks.  Take time this week to do a quick training and discussion using Oregon OSHA’s hazard alert.  

After this week it is clear that summer is here and now is the time to consider heat related illness, and how your district will address them.  As your activity levels ramp up, the hazards associated with heat related illness become a significant issue for workers.  We have all been focused on the COVID-19 crisis and how to operate with that and may have put aside our normal concerns related to everything else your district does.  Also, since Oregon OSHA has been focusing their attention to COVID-19, some of these hazards may have slid to the back of your minds.  In my conversations with Oregon OSHA, they have reminded me that the Program Directive PD-299 Preventing Heat Related Illness goes into effect on June 15, 2021.  That means that when they are reviewing accidents and complaints/referrals, they will be considering those issues through the lens of heat related illness. 

At times, the symptoms of heat stress don’t always present in obvious ways and often are mistaken as other medical issues.  This is a good time to remind all districts that employers in Oregon have the responsibility to manage the safety and health of their workers, and since it is an emphasis program, OSHA will be taking a deeper look into the issue of heat stress.  For more information about what you can do visit the Oregon OSHA Heat Stress Topic Page

Rhabdomyolysis is a serious health condition that often is correlated with heat related illness.  Due to the physical nature of their job, stresses on their bodies, and the excessive heat they are exposed to, Rhabdomyolysis is more common among firefighters (structural/wildland).  I am personally aware of four firefighters in the past three years who have been diagnosed with this ailment.  Although there is a higher frequency rate with firefighters, especially new recruits, this health condition can affect all workers in all types of districts. 

What are the signs and symptoms of rhabdomyolysis?

  • Muscle aches or pains out of proportion with the amount of exercise done
  • Muscle weakness and cramping
  • Tea-colored or cola-colored urine
  • Reduced or no urine output
  • Nausea or vomiting
  • Rapid heart rate
  • Abdominal pain
  • Confusion
  • Fever

What can you do?

  • Educate all employees about the signs, symptoms, and dangers of heat-related illness and Rhabdomyolysis
  • Conduct physically demanding activities during cooler parts of the day
  • Drink plenty of un-caffeinated fluids and take rest breaks as needed
  • Tell your supervisor immediately if you or a co-worker is experiencing symptoms of heat-related illness or rhabdomyolysis
  • Talk to your healthcare provider about your job and your increased risk for rhabdomyolysis

Please find the following Hazard Alert on the subject