Tom Kerr (TK): I’m Tom Kerr. Summer’s finally here, and as the weather warms up, it also creates some real issues for employees across the U.S. In fact, WCRI reports the probability of work-related accidents increases 5% to 6% when temperatures rise above 90 degrees. To talk about this issue in more detail, I’ve invited Melissa Martinez, clinical operations manager, of Enlyte’s ClinicalCare24 program, to discuss how the heat is affecting workers’ comp cases.
Melissa, thanks for joining us.
Melissa Martinez (MM): Hi, Tom. thanks for inviting me. It’s great to be a part of this show.
TK: So let’s dive in. Are you seeing an increase in heat illness injury claims, and if so, what are some possible reasons behind this?
MM: So, after doing some review on our end in terms of ClinicalCare24, we did not find that heat‑related incidences are going up. However, we do see that it’s been consistent. It’s about less than one percent of our calls.
But if clients, on the other hand, do see some increase in their calls related to heat illnesses or injuries, it’s likely related to the noted climate change. I’m sure everyone can see that the durations of heat have lengthened on a yearly basis; the duration of months that have the heat‑induced effects have been prolonged.
The heat in terms of temperature has shown an increase as well. So all those factors contribute to injury or injury claims related to heat.
TK: What specific industries are more likely to see heat‑related workers’ comp claims and why are these industries more at risk?
MM: So, there are industries such as distribution centers, manufacturing centers that typically see heat‑related work injuries. Although the environments are indoors, these environments may not be temperature‑controlled, and they put the employee at increased risk of heat-induced injuries.
Industries such as construction, public and utilities, lawn and garden, those are the obvious industries that have direct heat exposure. And on top of being directly in the heat, they have a longer duration of exposure of the heat. Some may have their full 8‑hour, 10‑hour shifts in these elements.
TK: When we talk about prolonged exposure to heat, what are some medical conditions that are caused by heat-related illnesses and injuries?
MM: I’m going to focus on the top two that are more severe in terms of putting an employee at risk for being exposed to heat, and the most significant one is heat stroke.
I’m sure people have heard the term heat stroke, and it’s the most serious heat‑related injury. It occurs when the body can no longer control the body temperature because it rises rapidly, the sweating mechanism fails, and then heat stroke can come into play.
Symptoms that are involved with this are confusion and loss of consciousness is probably the most relevant one. The individual becomes hot and the skin starts to become dry or the person is profusely sweating. Worst case scenario is the employee can go into seizure and that heat stroke can be very fatal.
The next one that is a prerequisite to a heat stroke is heat exhaustion. And when heat exhaustion comes into play, it’s the body’s response to excessive loss of water, salt, electrolytes, etc. Through this excessive sweating, there’s most likely symptoms such as headache, nausea, vomiting, dizziness, weakness, irritability and increase in thirst. Also, the body temperature starts to elevate.
TK: OK, let’s follow up on that. When these more serious symptoms occur, does the employee typically realize what’s happening as they develop? Or can these symptoms come on suddenly before it becomes a more critical situation?
MM: So, I think it’s dependent on the duration an employee has been within that type of industry. Some can notice it early on and some, it progresses, and they tend to keep working through it and then they get caught off guard.
But I would say for the most part, people will start recognizing that they’re feeling lethargic. They start feeling kind of sluggish, tired. And then they also start picking up on the symptom of sweating, profusely. It’s common for everyone to sweat. That’s your body’s mechanism of cooling you down as well. But, severe sweating is a symptom that most employees would pick up on. But again, it’s dependent on the employee and his or her experience in the field that they’re working in.
If someone’s new to the industry, they may not pick up on it as fast as somebody who’s been in the industry for several years.
TK: Are some employees more at risk for developing heat‑related disorders?
MM: That’s definitely a good question and something that employers should take into consideration.
People who are at more at risk for heat‑related disorders include elderly adults, those with obesity, those who have an increased risk of heat‑related disorders, those who are diabetic, those who have heart disease, lung disease, or kidney disease.
Also, people who take diet pills that typically contain caffeine are at a high risk as well as those who have had excessive alcohol consumption. People typically don’t consider the last two as being at risk for developing heat‑related conditions, but they definitely are.
TK: Why is that? Is it because they dehydrate at a faster rate?
MM: Yes. caffeine, alcohol, can be dehydrating if your body’s trying to regulate its temperature. It’s kind of like a diuretic. Your body increases urine frequency and, in the heat, you’re going to be producing more sweat. Being in that heat, your body’s working that much harder. So, on top of having the diuretic in your body, having the exposure to the heat, you’re more at risk for having a heat‑related condition.
TK: Are employers able to take specific actions to help stave off these claims before they begin?
MM: Absolutely. Prevention is key to ensuring that your employees are safe during summer times where we have peak temperatures. So, first and foremost, not placing a high‑risk employee in these hot work environments for extended amount of times is key. Having water or electrolyte replacement drinks readily available to employees, and ensuring that they are consistently hydrated is very important.
Also, providing shade if they have limited access to it. For example, for construction workers, there’s really not often too much shade. But having a pop‑up tent, a shaded area to provide for your staff to have that moment to step out of the sun is definitely beneficial. If you have a fan as an option, that would be something you should take into consideration as well.
It’s also important to properly train your employees to understand the signs and symptoms of heat‑related conditions. We talked about the employees that have experience versus non‑experience in working in hot environments. Educating them on the signs and symptoms to look for and when to seek help is very important.
Taking into consideration the temperature or heat index and, if it’s elevated, take into consideration alternative work environments. If it cannot be altered, ensure that, again, the water, electrolyte‑replacing beverage is available to the employee.
And one key thing is offering your employees regular breaks under the shade or cool areas. It is recommended that they take 5‑minute water breaks in the shade every 25 minutes. And then, ensuring that your employees are dressing with lightweight clothing and that they’re not layering is also going to be beneficial.
TK: OK. So there’s a lot of great prevention strategies you offered. Can you briefly explain what CC24 is and how it helps employees quickly address medical concerns on the job?
MM: Absolutely. So, CC24 or ClinicalCare24, is a 24/7 call center, and we triage injured employees. What we offer to our clients is, of course, the injury reporting aspect of it, but most importantly is we provide a recommendation of care for an employee.
So that is our direct benefit to our clients, is providing a recommendation of care and then assisting the employee with a referral if needed.
TK: So, if someone calls into CC24 with a heat-related issue, how would a nurse handle that situation?
MM: So when an employee calls into the nurse line our priority is to determine the severity of their symptom and the type of first aid we offer.
For non-emergent heat-related issues, we’re likely going to advise them to move to a cool environment, possibly an air‑conditioned area. If that’s not available, ask them to step into a shaded area. We would advise the employee be provided with something to drink like water or, preferably, electrolyte beverage.
We advise the employee to be provided with wet rags to place around the neck and the body to start to cool that person down. If the employee has layers of clothing, we ask him or her to remove those multiple layers.
And, if able, we would like the employee to lie down and elevate the feet. Those are the immediate type of first‑aid items that we would offer or advise to our employees. And we monitor the person’s condition from there.
TK: And feet elevation does what? Help with circulation to improve blood flow to the brain?
MM: Mm‑Hmm. Promotes circulation. And lying down helps with all that, but they are at risk for falling, too. So, getting them sitting down, lying down is in their best interest as well, just in case they’re moving into the next steps of potentially passing out.
TK: Thanks, Melissa. And we’ll be back with another podcast soon. Until then, thanks for listening.