Accident Prevention e-News June 2008	Volume 3/Issue 6/June 2008
In this Issue: 3 MSD myths Recertifying your JHSC members? TDGA amendments: are you up to speed? Heat stress quiz In the News

3 MSD myths

Misconceptions about musculoskeletal disorders (MSDs) could be compromising the success of return to work (RTW) programs, says Dr. Pierre Côté, a speaker at IAPA’s recent national conference and trade show, Health & Safety Canada 2008.

In his presentation, Côté identified three MSD myths based on current research. Côté is a senior scientist, University Health Network Rehabilitation Solutions, an assistant professor in University of Toronto’s Department of Public Health Sciences, and a new investigator, Canadian Institute of Health Research.

Myth 1: musculoskeletal injuries are isolated events, and permanent recovery should occur quickly. Reality: recovery time varies, and recurrences are common.

Drawing on findings from research that he and colleagues conducted and published in April,¹ Côté told delegates that almost a third of workers with an incident episode of back pain experience recurrent spells of absenteeism the following year.

“Despite new disability management and clinical interventions designed to shorten work absences,” notes the published article, “reducing work disability associated with back pain remains an elusive goal.”

Côté attributed this in part to a continuing reliance on models of back pain that conceptualize it as an acute condition following a uni-directional path over time, rather than as a chronic disorder with recurring episodes of disabling pain.

One such model assumes that the disabling effects end when an injured worker returns to work. Another more recent approach, said Côté, is the ‘‘phases of disability model.’’ This model assumes that patients progress through acute, sub-acute and chronic phases of back pain, and either ultimately return to work or become permanently disabled.

Neither model, he said, acknowledges that the disabling effects of back pain can recur. However, recent research indicates that the course of back pain is often episodic. Furthermore, a substantial minority of patients does not experience resolution of pain and disability.

Côté warned that continuing to rely on models of back pain as an acute condition will likely point disability management strategies toward the wrong targets, and produce misleading evaluations of health care outcomes for workers with back pain.

Myth 2: musculoskeletal injuries are physical health problems, and therefore physical recovery is the best predictor of return to work. Reality: workers with musculoskeletal conditions may also develop mental health dysfunction, and mental health influences return to work.

Côté cited as an example a 2003 study that found a relationship between neck or back pain and the development of depression. Workers with mild or intense pain were two times as likely to become depressed as workers with no pain; workers with disabling pain, 2.5 times as likely.

Given that back injuries are among the most prevalent and costly workplace injuries, better forecasting of return-to-work outcomes, especially for those at high risk of poor outcomes, could ease the disability burden for everyone affected. With this in mind, Côté and colleagues published results last year from a study that tested a number of biopsychosocial, cognitive-behavioural, and work-related factors as a means of identifying the best predictors of work disability following a back injury.²

What weren’t useful predictors in most cases, the researchers found, were radiography, imaging and other clinical measures of the causes of back injuries.

More helpful were self-reported severity measures. But here again usefulness varied. For example, “baseline physical functioning and overall mental and physical health status were more predictive of specific patterns of post-injury employment than were pain intensity measures.” Particularly helpful were measures of health-related quality of life. This, said Côté, suggests that identifying and treating workers with poor mental health at the time of onset of back pain could improve their employment outcomes.

Myth 3: recovery and return to work are influenced by workers’ motivation to return, and by medical treatment and rehabilitation. Reality: the single most important influence on employment stability after the onset of back pain is worker satisfaction with how employers respond to claims, said Côté. A study conducted by Côté and others and published in 2007 suggests satisfaction with claims management is about equal to the severity of back pain in explaining differences in the stability of subsequent employment activity.³

Consequently, said Côté, disease or disability management programs make a serious mistake if they address back pain as a condition whose outcomes are primarily determined by satisfaction with health care.

The findings presented in the published article suggest that “there are unrealized opportunities for reducing the costs of occupational back pain by developing improved strategies for managing the relationships between employers and workers who file back claims. The opportunities revealed in this article are for large, well-managed firms with well-developed disability management programs. Opportunities for greater improvements are likely for smaller firms and for firms of any size without well-structured disability management plans.”

Côté concluded his presentation at Health & Safety Canada 2008 with three key messages:

• musculoskeletal injuries follow a chronic and episodic course
• satisfaction with the employer’s management of the claim promotes better RTW outcomes, and
• mental health influences recovery.

How IAPA can help

1. Download the MSD Prevention Guideline for Ontario, and accompanying resource manual and toolbox. These materials, produced by the Occupational Health and Safety Council of Ontario, enable workplaces to devise a comprehensive strategy for musculoskeletal disorder (MSD) prevention.
2. Check out IAPA’s array of ergonomics-related training, products, and free downloads. Two of our newest training offerings are Nuts and Bolts of Implementing an MSD Prevention Program (see IAPA’s special summer offer) and Back Safety 101 (DVD and video formats).
3. Request on-site delivery of IAPA’s Psychosocial Risk Management course to help improve return to work outcomes.
4. Ask an ergonomics specialist how IAPA consulting and assessments can help you reduce MSDs. For instance, IAPA ergonomics specialists can assist you with
   • ergonomics assessments: office and industrial
   • physical demands analyses (PDAs)
   • job task analyses

References

1. Pierre Côté, Marjorie L. Baldwin, William G. Johnson, John W. Frank, Richard J. Butler, “Patterns of sick-leave and health outcomes in injured workers with back pain,” European Spine Journal, April 2008, pp. 484-493.

2. Marjorie L. Baldwin, Richard J. Butler, William G. Johnson, Pierre Côté, “Self-reported Severity Measures as Predictors of Return-to-work Outcomes in Occupational Back Pain,” Journal of Occupational Rehabilitation, December 2007, Vol. 17, No. 4, pp. 683-700.

3. Richard J. Butler, William G. Johnson, Pierre Côté, “It Pays to be Nice: Employer-Worker Relationships and the Management of Back Pain Claims,” Journal of Occupational and Environmental Medicine, Volume 49, Number 2, February 2007, pp. 214–225

Recertifying your JHSC members?

With increasing frequency, member firms are asking IAPA whether their certified joint health and safety committee (JHSC) members require recertification. AP e-News asked IAPA principal consultant John VanLenthe this and other questions about certification and JHSCs.

“Recertification? The law says nothing about it.”

VanLenthe believes the misconception originates in part from expiry dates that appeared on the first certification cards issued. “The cards no longer have expiry dates,” says VanLenthe.

So it’s not required, but is there any value in retaking certification training?

“I’ve dealt with companies whose committees just thought they were doing a fantastic job, and they weren’t. This means they’re missing opportunities to prevent injuries, and fewer injuries means better performance. Retraining workers hones their skills, updates them on changes, and helps them make a greater contribution.”

What return on investment can employers expect from certification training?

“Look at it this way. Your committee has legal obligations to fulfill. Give the certified members proper training, and they’ll fulfill those obligations more effectively and efficiently. It maximizes the value of the time and effort they put into it, and generates more productive results for the workplace. That’s why some employers send all committee members and others for certification training.

“Here’s another benefit: an active effective committee can indicate to workers that the company is committed to improving health and safety. However,” warns VanLenthe, “a committee can’t drive a health and safety culture. The committee can enhance this culture, but the impetus has to come from the top.”

What’s the purpose behind certification?

“Certification involves training in health and safety law, and the identification, assessment and control of significant hazards,” says VanLenthe.

As described by the Workplace Safety and Insurance Board, certification provides the designated JHSC members with the training needed to

• describe hazards and how they may cause injury or illness
• identify relevant legislation, standards and guidelines for the hazards
• describe how to identify and assess them
• describe ways of controlling them, and
• prepare an action plan to identify, assess and control the hazards, based on an actual workplace situation.

Who must be certified?

Under the Occupational Health and Safety Act, most workplaces with 20 or more workers must have at least one worker and one management person serve as certified JHSC members.

How do you become certified?

Certification involves training in two specific areas.

Certification Part One covers the fundamentals of health and safety that apply to all workplaces. Key topics include:

• health, safety and the law
• workplace safety
• workplace health
• inspections
• investigations
• JHSCs.

Certification Part Two focuses on significant hazards that are specific to your workplace or industry sector. It gives you the tools to recognize and assess those hazards, and recommend ways to control and/or eliminate them.

How does certification help the JHSC?

First, certified members can apply their knowledge directly to the duties of JHSCs as set out by law. Some of these duties include:

• identifying hazards
• conducting monthly workplace inspections
• recommending ways to improve and maintain the health and safety of workers.

Second, certified members who perform these duties well and understand how they fit into overall health and safety management bring a much broader perspective to problem-solving and hazard prevention. A broader perspective is vital, says VanLenthe. “For instance, effective committees look beyond their day-to-day obligations and ask themselves, ‘Where have we been focusing our efforts? Where have we been making our recommendations? What kind of changes have we made in the last three months? Six months? Twelve months? Are these changes working?’ If they’re not,” continues VanLenthe, “the workplace is going to be confronted by the same problems again and again.”

What qualities would you look for in potential certified JHSC members?

“Openness,” says VanLenthe. “Effective certified members have to remain unbiased. They have to be open, and consider everyone’s perspective. They have to look, with clear sight, at what is, what has been done, what should be should be done. They then have to be able to convert this information into realistic, viable recommendations.”

What do certified members contribute?

“They can apply their understanding of the law, the responsibilities of workplace parties, and the basics of workplace inspections and hazard identification and control to controlling and eliminating hazards. Speaking pragmatically, effective members bring perspective. Is the matter at hand a recurring problem? If so, what recommendations were made before? Were they acted on? For repeating or new problems, what can be done to prevent a recurrence?”

Can certification training help foster a health and safety culture?

“Yes, but only if the JHSC itself has the support of management. This support is an indication of management commitment. Workers who see that management is committed will also make a commitment. However, a committee can’t create a health and safety culture. The impetus has to come from the top.”

What’s the value of 3-day training for Certification Part One, versus 2-day?

“Depends on the person being trained,” says VanLenthe. “Has this person had any previous health and safety training? For instance, has he or she taken IAPA courses like ‘Investigating Accidents,’ ‘Safety, Health and the Law’ or ‘Joint Health and Safety Committees?’

“If they’re a brand new committee member, have had little to no prior health and safety training, and have just been selected to become a certified member, I suggest every single time, ‘Do the 3-day course.’ The workshopping in this course gives people an understanding of how to use the information in a practical, day-to-day situation.

If the person has had some training, then the 2-day course may be enough. It’s a solid refresher.”

What do effective committees do right?

According to John VanLenthe, effective committees

1. seek out opportunities for improvement, not just problems that need fixing. The difference: a broader perspective that encourages a process or systems approach, rather than a tactical or band-aid approach.
2. track previous recommendations to see whether they have been implemented. “If they have been, are they working? ‘We’ve made these changes, so are we seeing a reduction in injury frequency? Are we seeing a reduction in injury types? Are we seeing a reduction in the number of hazards reported by workers?’ It’s an ongoing process.”
3. look for what’s working well. “Unfortunately,” says VanLenthe, “a lot of committees focus solely on ‘What can we find that’s wrong,’ with no thought to ‘What can we find that’s right.’ ” Identifying and promoting successful practices builds workplace commitment to, and reinforces the value of, a health and safety culture.
4. validate measurements. If the number of injuries is going down, effective committees figure out why. “If you’ve had a 50% reduction in injuries involving machines, and it coincided with a machine guarding campaign, then you can be pretty sure the campaign is working.” Conversely, if there was no apparent reason for the drop, you can expect the numbers will probably rise again because the hazards are still there.
5. evolve. Effective JHSCs review their terms of reference and update as required. They ensure everyone has the training needed to ensure committees function well. They create openings for new members with fresh perspectives.

How IAPA can help

For Certification Part One, IAPA offers three options:

• generic
• manufacturing
• offices

For Certification Part Two, IAPA offers these industry-specific options:

• food and beverage
• foundry
• manufacturing
• office
• plastics
• printing
• woodworking

All courses can be delivered on site. Check our special rates for multiple registrations (4 or more).

IAPA also offers

• a Joint Health and Safety Committee Kit that includes all the essentials for guides, tip sheets, forms and other support material for getting a JHSC up and running effectively.
• Determining Significant Hazards at Work: A Guide for Employers and JHSCs, a free download.

TDGA amendments: are you up to speed?

Every year an estimated 30 million shipments of dangerous goods occur in Canada. These shipments are subject to the federal Transportation of Dangerous Goods (TDG) Regulations.

Earlier this year, a number of regulatory changes came into effect. The changes affect 12 of the regulations’ 16 parts, plus three of their schedules. Known as Amendment 6, the changes clarify requirements, address safety issues, and align the regulations with international recommendations and requirements, as well as US dangerous goods regulations.

Among the changes are the following.

Part 1: Coming into force, repeal, interpretation, general provisions and special cases

Includes new interpretations, and updates the table of documents referring to safety standards and safety requirements, and the list of definitions. Also includes changes to general provisions and special cases.

Part 2: Classification

Among the key changes, infectious substances are now classified into two categories instead of four risk groups. This harmonizes the regulations with recent changes made to the UN Recommendations. Other important changes involve

• the flash point for Class 3 Flammable Liquids (60oC instead of 60.5oC)
• limit values for inhalation, dermal and oral toxicity of Class 6.1 Toxic Substances
• classification requirements for Class 7 Radioactive Materials and Class 9 Miscellaneous Products, Substances and Organisms.

Part 3: Documentation

Includes changes to the way subsidiary classes and packing groups must be shown on shipping documents. Removes requirements for risk groups. The unit of measure for the quantity of dangerous goods transported can now also be displayed with a unit of measure acceptable for use under the International System of Units (SI system). For example 1 t = 1,000 kg.

Part 4: Dangerous goods safety marks

Modifies 14 sections, such as carrier responsibilities, and requirements relating to the size and colour of the UN number. Also clarifies the requirements for Class 2, Gases, and adds new

• requirements for displaying subsidiary class placards in certain circumstances
• requirements for displaying dangerous goods safety marks for anhydrous ammonia, infectious substances and radioactive materials
• placards and labels to the appendix of Part 4.

Part 5: Means of containment

Includes changes to the table used to determine which explosives can be stored or transported together in the same means of transport, and new requirements for cylinders containing Class 2, Gases and Infectious Substances of Class 6.2.

Part 7: Emergency Response Assistance Plan (ERAP)

Section 7.1 now has nine subsections to better define the requirements for ERAPs. These additions introduce new situations for which an ERAP is required. One of the new subsections introduces requirements to further define the responsibility of the person responsible for the ERAP.

Part 8: Accidental release and imminent accidental release report requirements

Includes two minor modifications involving requirements for dangerous goods in Class 1, Explosives, and Class 6.2, Infectious Substances.

Part 9: Road

A major change establishes that, from August 31, 2008, placards and labels displayed on a means of containment transporting goods in Class 2.3, Toxic Gases, and Class 6.1, Toxic Substances, must be those required by the TDG Regulations. These placards and labels may be displayed before August 31, 2008. Other modifications

• change the requirements for the description of dangerous goods on shipping documents for dangerous goods transported from the US to Canada or passing through Canada
• clarify that exemptions in 49 CFR for safety marks and packaging that are not permitted in the TDG Regulations are not granted reciprocity
• clarify requirements regarding the display of dangerous goods marks when dangerous goods are transported by road vehicle to or from an aircraft, an aerodrome, or an air cargo facility as well as to or from a ship, a port facility or a marine terminal.

A new section contains new requirements to establish the maximum net explosives quantity that can be transported in a road vehicle.

Part 10: Rail

Makes modifications identical to Part 9 (Road) with regard to the description of dangerous goods on shipping documents and requirements to display dangerous goods marks. Other changes include

• rescinding the prohibition to transport a highway tank that contains dangerous goods by railway vehicle
• a new method to locate railway vehicles containing dangerous goods in a train
• a new table for coupling railway vehicles
• a new inspection requirement for owners of railway vehicles subject to a coupling report.

Part 11: Marine

Changes affect the requirements regarding means of containment containing dangerous goods during international and home-trade voyage, Class 1.

Part 12: Air

Clarifies some existing requirements and aligns the TDG Regulations with recent changes in the ICAO Technical Instructions. Also aligns this part with revised terms in Part 1, such as definitions of "capacity" and "gross mass."

Part 16: Inspectors

Three new sections introduce requirements concerning the detention of dangerous goods or means of containment, direction to remedy non-compliance, and direction not to import or to return to place of origin dangerous goods or means of containment.

Source: Overview of Amendment 6 of the TDG Regulations, Transport Canada.

Are your training certificates up to date? IAPA can help

Under the Transportation of Dangerous Goods Regulations, anyone who handles, offers for transport or transports dangerous goods must be adequately trained and hold a valid training certificate. These certificates have expiry dates:

• for transport by aircraft, 24 months after its date of issuance
• for transport by road vehicle, railway vehicle or ship, 36 months after its date of issuance.

Sign up for IAPA’s revised Transportation of Dangerous Goods course to obtain or update a training certificate, delivered on site or through public training, to find out

• about your company’s responsibilities under the Transportation of Dangerous Goods Act and Regulations
• how Amendment 6 changes affect you and your company.

Heat stress quiz

“Heat is by far the number one killer among all weather events,” warns the US National Weather Service Forecast Office. Take note, because Environment Canada says this summer could be hotter than usual.

How knowledgeable are you about heat stress? Better yet, how prepared are you? Test yourself with the following questions.

1. Humidity reduces the risk of heat stress.
   True False
2. Workers over age 40 tolerate heat better than younger workers.
   True False
3. Workers unused to a hot environment, such as summer students, should spend only 20% of their first shift in this environment.
   True False
4. Increasing air movement in a hot environment is always a good idea.
   True False
5. Workers should drink 250 mls of cool water every 20 minutes or so.
   True False
6. The Humidex is an ideal safety measurement for hot environments.
   True False
7. Keep people suffering from heat stress warm, to prevent them from going into shock.
   True False
8. My workplace’s heat stress program provides solid protection through engineering, administrative and other controls.
   True False Don’t know

Check the Answers

How IAPA can help

A proactive and comprehensive heat stress program is a sound investment not only for the existing workforce but also for incoming workers.

IAPA offers a number of web resources—fact sheets, guides, tools, and more—on heat stress and other hot weather topics that can help you enhance your heat stress program.

In the News

IAPA and NQI form a strategic alliance

A new strategic alliance between IAPA and National Quality Institute (NQI) will offer member firms greater opportunities to integrate health and wellness issues into their OHS programming.

As of May 1, 2008, IAPA is an authorized provider of NQI Healthy Workplace® courses and related materials, the NQI Progressive Excellence Program (NQI PEP®) and related materials, and related services. NQI, an independent, not-for-profit organization, is Canada’s leading authority on workplace excellence based on quality systems and healthy workplace criteria.

“We’re pleased to partner with NQI in this joint effort to raise the profile of workplace health, safety, and wellness, as well as identify the advantages of a business excellence program that IAPA has benefited from in the past,” says IAPA president and CEO Maureen Shaw. “With IAPA and NQI working collaboratively and sharing our collective knowledge, expertise, and talent, we can do more together to assist organizations in their journey towards becoming healthy workplaces. And, it will only help us all to get closer to that ultimate goal of zero workplace injuries, illness, and deaths in our workplaces.”

NQI Healthy Workplace courses cover material developed by NQI, Health Canada, and a team of key health professionals, including IAPA. The courses address a broad-based approach to health and wellness issues in the workplace, bringing together environmental, physical, mental, safety, and social issues into a strategic model that helps organizations set goals and manage their internal wellness programs.

NQI PEP is designed to help organizations improve their operations, as well as boost their overall business results, by providing organizations with the framework and strategic context for ISO and other systems such as hospital accreditation, Six Sigma, LEAN manufacturing, and customer relationship management so that an organization can incorporate other improvement initiatives into a holistic, integrated management system.

IAPA staff will be trained by NQI personnel to become certified instructors of NQI courses. IAPA will also be equipped to provide training and consulting work with the NQI Healthy Workplace Program and NQI PEP Program at all levels.

"NQI is very pleased to enter into this strategic alliance with IAPA, a long-time partner and client of ours," said Allan Ebedes, president and CEO of NQI. "Together, NQI and IAPA will be able to train and coach even more organizations to become healthy workplaces and role models for organizational excellence."

Protect young workers, protect your firm

This month, Ministry of Labour inspectors will be conducting a young and new worker safety blitz, focusing on the service and manufacturing industries. IAPA offers self-directed training courses and tip sheets that can help all workplace parties, as well as young workers’ parents, reduce the risk of injury and illness among this group of workers.

OHS simulcast reaches 100 schools

In a pre-emptive effort to reach young workers before they enter the workplace, Our Youth at Work Foundation recently coordinated youth health and safety simulcast presentation that reached out to 100 schools in 50 communities.

The simulcast consists of a video feed from Rob Ellis telling his story and bringing home a hard-hitting safety message. Rob Ellis’s son David died in February 1999 from injuries sustained while cleaning an industrial mixer in a bakery. It was his second day on the job. David, 18, had received only minimal training, and was unaware his employer had ignored a mandatory order to install a low-cost safety device on the outside of the mixer.

Following the simulcast, students in each school were able to ask health and safety questions of on-site volunteers (corporate executives). For most students, this is their first opportunity to interact with senior management as prospective employees.

One such corporate team, comprising CSA Group president and CEO Robert M. Griffin and colleagues from CSA and CSA International Group, took the stage at Oakville’s Holy Trinity Catholic Secondary School.

“CSA Group’s work is all about life, and proper occupational health and safety can truly mean the difference between life and death,” says Griffin. “This is why CSA Group is committed to supporting events such as the Our Youth at Work simulcast. It provides us the opportunity to meet with young workers and listen to their concerns about on-the-job safety. This not only helps CSA Group improve its own best practices but it also enables us to gain new insights into how standards and certification and testing can play a bigger role in helping to protect Canadian workers.”

The program started in 2005 with only six schools and six corporate teams, and has grown each year. For example, this was the first year that Ottawa schools participated. The simulcast reached 3,000 students in nine Ottawa schools.

The corporate champions “really connected with our students and… you could hear a pin drop during the [video] simulcast,” says Chuck Daly, a co-op teacher at St. Pius X High School in Ottawa. “The question-and-answer session was excellent, with great questions and informative answers. It was a pleasure to be part of such a positive experience.”

UWO student wins 2008 safe design award

Minerva Canada Safety Management Education Inc. has presented its 2008 James Ham Safe Design Award Competition to Mark Cicero, an engineering undergraduate student from the University of Western Ontario.

The award challenges Ontario university engineering students to make an original contribution toward integrating safety into engineering design.

Cicero took the top Minerva safety award for designing a safety management audit training database system that greatly assisted his summer employer in making their employees more aware and responsive to workplace hazards. The data collected helped to eliminate recurring injuries. Mark received a plaque and a cheque for $3,500 from Minerva Canada president and CEO Tony Pasteris and IAPA president and CEO Maureen Shaw. “Engineering is a critical part of a safe future,” said Shaw, “because it allows us to integrate safety right into work processes and systems.”

The award, presented at Health & Safety Canada 2008, IAPA’s national conference and trade show, honours James Milton Ham, whose Royal Commission Report on Health and Safety led to the Ontario Occupational Health and Safety Act in 1979 and the adoption of the Internal Responsibility System.

Minerva Canada is a not-for-profit organization dedicated to promoting the teaching of safety, health and environmental management in post secondary schools across Canada.

Heat stress quiz answers

1. Humidity reduces the risk of heat stress.
   False
   The greater the humidity, the longer it takes for sweat to evaporate. In effect, humidity compromises the efficiency of our body’s primary cooling mechanism.
   
   
2. Workers over age 40 tolerate heat better than younger workers.
   False
   Generally workers over 40 have less ability to sweat, making them more prone to heat stress.
   
   
3. Workers unused to a hot environment, such as summer students, should spend only 20% of their first shift in this environment.
   True
   After their first day, these workers can increase their exposure by another 20% daily. Experienced workers can spend up to 50% of day one in a hot environment; 60% on day two; and 80% on day three.
   
   
4. Increasing air movement in a hot environment is always a good idea.
   False
   Increasing air movement may sound reasonable, but it doesn’t always help. When air temperature exceeds 35° Celsius, air movement can actually decrease our body’s natural cooling mechanisms, and thus increase the body’s heat load.
   
   
5. Workers should drink 250 mls of cool water every 20 minutes or so.
   True
   Replenishing water lost through perspiration is essential. It helps us sweat, and keeps our organs functioning properly.
   
   
6. The Humidex is an ideal safety measurement for hot environments.
   False
   The Humidex is a useful comfort factor, but does not take into account wind speed, radiant heat from objects, or body cooling due to sweat evaporation. A better indicator is the Wet Bulb Globe Temperature Index (WBGT).
   
   
7. Keep people suffering from heat stress warm, to prevent them from going into shock.
   False
   The goal is to help cool the person’s body. There are many options, ranging from removing damp clothing to spraying the person with cool water. If the person’s body temperature exceeds 41° Celsius, call an ambulance. This condition can kill quickly.
   
   
   
8. My workplace’s heat stress program provides solid protection through engineering, administrative and other controls.
   If you have anything less than 100% certainty that your workers are fully protected, review the resources identified below.