June 23, 2022 / Margaret C. Morrissey

Does Your Work Site Need a Heat Stress Management Plan?

In April, the National Integrated Heat Health Information System (NIHHIS), an organization jointly developed by CDC and the National Oceanic and Atmospheric Administration, hosted a three-day meeting to learn about and leverage heat and health activities, opportunities, and resources; expand and strengthen partnerships and networks; and foster a shared vision and path forward for equitable, heat-resilient communities.

Along with government agencies, work organizations, universities, and professional organizations, AIHA was selected by OSHA leadership to present during the “How Do We Keep Our Workers Safe from Heat?” session. AIHA’s role in the session was to speak about the on-the-ground challenges with heat standards and protections, implementation, and best practices in the field for occupational heat injury and illness prevention. I was humbled and thrilled to be selected to represent AIHA and the newly formed Thermal Stress Working Group during the NIHHIS meeting. Here, I will summarize key information from our presentation on heat stress management plans.

The first consideration that should be made when thinking about a heat stress management plan is determining whether your work site needs one in the first place. There are several characteristics within the work environment that must be reviewed to determine whether heat is a hazard. These characteristics include:

  • Environmental conditions. Is it hot or humid? Are workers exposed to solar radiation or radiation from machinery? Is there little air movement in the workplace?
  • Physically demanding work. Are workers performing at moderate to heavy exertion?
  • Personal protective equipment. Are workers required to wear encapsulating personal protective gear, and are they unable to remove it during work?
  • Rest breaks. Are there adequate rest breaks during work to ensure workers are rested, hydrating, re-fueling, and recovering?
  • Reported symptoms of heat strain, heat illness, heat injury, and exertional heat stroke. Have workers reported experiencing any heat illnesses or injuries?
  • Individual characteristics. Do your employees have any predisposing conditions that could increase their risk of developing a heat-related injury or illness? For example, do workers come to work dehydrated or have medical conditions such as hypertension or diabetes?

Even if you answer “no” to all these questions, you should revisit them every six months. Your workers may experience little heat stress now, but this may change as ambient temperatures continue to rise due to climate change. If you decide your work site needs a heat stress management plan, you must define the prevention strategies that will be implemented. These strategies must be tailored to the industry and working environment; there is no one-size-fits-all approach to protecting against heat stress.

For an effective heat stress management plan, employers must consider two levels of prevention: preventing heat-related injuries or illnesses from happening in the first place, and preventing heat-related fatalities. No matter how many prevention strategies you have in place, no plan is infallible. It is essential to define a heat policy or procedure that includes procedures for exertional heat stroke or heat-related medical emergencies.

The National Heat Safety Coalition, a division of the Korey Stringer Institute focused on preventing heat-related injuries and illnesses in laborers, published a consensus document in the August 2021 issue of the journal GeoHealth that focused on heat safety in the workplace and recommendations to protect the health, safety, and productivity of workers. It discusses the eight components of a heat stress management plan and how they can be implemented. Each recommendation was systematically scored by 51 heat stress experts and were included in the final document only if they were determined to be feasible, evidence-based, and clear. The presentation to NIHHIS highlighted some of these components, such as heat safety training, hydration, and environmental monitoring, to provide clear examples of what employers, safety managers, and workers should consider when implementing prevention strategies.

For further reading and discussion, please visit the websites of the National Heat Safety Coalition and the Korey Stringer Institute.


GeoHealth: “Heat Safety in the Workplace: Modified Delphi Consensus to Establish Strategies and Resources to Protect the U.S. Workers” (August 2021).

The Synergist: “Heat Hazards: Protecting Workers in Hot Environments” (April 2016).

The Synergist: “It’s the Heat—And the Humidity: Critical Factors for Heat Stress Assessment and Prevention” (April 2020).

The Synergist: “Preventing Heat-Related Illnesses: How to Reduce Heat Burden from PPE and Other Factors” (June 2022).

Margaret C. Morrissey

Margaret C. Morrissey, PhD, is director of occupational and military safety at the Korey Stringer Institute, president of the National Heat Safety Coalition, and secretary of the AIHA Thermal Stress Working Group.


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