Ergonomics of the thermal environment - Medical supervision of individuals exposed to extreme hot or cold environments (ISO 12894:2001)

This International Standard provides guidance to those concerned with the safety of human exposures to extreme hot or cold thermal environments, about the medical fitness assessment and health monitoring which may be appropriate prior to and during such exposures. It is intended to assist those with responsibility for such exposures to reach decisions about the appropriate level of medical supervision in different situations. The standard presents guidance which should be read and used in the context of other guidance and legislation applying to each particular situation.

Ergonomie des Umgebungsklimas - Medizinische Überwachung von Personen, die einer extrem heißen oder kalten Umgebung ausgesetzt sind (ISO 12894:2001)

Diese Internationale Norm stellt Ratschläge für die Verantwortlichen zur Verfügung, die sich mit der Sicherheit bei der Exposition von Menschen gegenüber extrem heißen oder kalten thermischen Umgebungen befassen. Extreme thermische Umgebungen sind solche, die zu einem hohen Maß von Wärmezufuhr zum oder von Wärmeverlust des Körpers führen. Eine genaue Definition solcher Umgebungen ist nicht einfach aufzustellen, da die Veränderungen der Wärmespeicherung des Körpers ebenso von der Bekleidung und der körperlichen Tätigkeit wie von den Kennwerten der klimatischen Umgebung abhängen. Als Anleitung könnten die Grenzwerte extremer Umgebungen wie folgt angesehen werden: für heiße Umgebungen eine mit dem Feuchtkugelthermometer (WBGT-Index) gemessene Temperatur von 25 °C, für kalte Umgebungen eine Lufttemperatur von 0 °C oder darunter.
Extreme Umgebungen können nur für begrenzte Dauer ertragen werden, bis ein Risiko der Gesundheits-schädigung entsteht. Es sind Kontrollmaßnahmen erforderlich, um die Sicherheit der so exponierten Personen sicherzustellen, von denen eine die Durchführung einer geeigneten medizinischen Überwachung vor und während der Exposition ist.
Ziel dieser Internationalen Norm ist, die für solche Expositionen Verantwortlichen bei der Fällung von Entscheidungen über das geeignete Niveau der medizinischen Überwachung in unterschiedlichen Situationen zu unterstützen. Die Norm sollte im Zusammenhang mit anderen einschlägigen Anleitungen und gesetzlichen bzw. Verwaltungsbestim-mungen gelesen und angewendet werden.

Ergonomie des ambiances thermiques - Surveillance médicale des personnes exposées à la chaleur ou au froid extrêmes (ISO 12894:2001)

Les études en laboratoire ou en chambre climatique pour lesquelles la présente Norme internationale sera applicable sont celles au cours desquelles des personnes peuvent être exposées à des conditions thermiques ambiantes élevées ou basses, ou à un réchauffement ou refroidissement local. Ces études peuvent par exemple analyser les réactions physiologiques ou psychophysiques à l'environnement, ou les avantages fournis par des vêtements ou autre équipement de protection individuelle. Les recherches scientifiques et démonstrations pour enseigner les objectifs sont incluses. Dans certains pays, de telles études sont soumises à une législation spécifique et il convient, dans tous les cas, que les expositions expérimentales soient conduites dans le cadre de critères éthiques acceptés, comme détaillés dans les conventions nationales et internationales applicables (voir annexe A et Bibliographie). Les ambiances extrêmes peuvent ne constituer qu'un des éléments de la contrainte physiologique totale imposée dans une étude. Dans ce cas, il convient également d'obtenir un avis approprié pour ce qui concerne la surveillance médicale requise avant d'exposer le sujet aux autres facteurs de contrainte impliqués, par exemple la vibration du corps entier. Dans certains cas, des études ergonomiques sont effectuées sur le site, par exemple pour établir la contrainte physiologique induite par certaines activités. Si la contrainte globale induite par une tâche est augmentée du fait de l'étude proposée, la présente Norme internationale est applicable. La présente Norme internationale n'est pas applicable à l'utilisation d'une hypothermie ou d'une hyperthermie comme moyen d'examen ou de traitement médical.

Ergonomija toplotnega okolja - Zdravstveni nadzor oseb, ki so izpostavljene izjemno vročim ali hladnim okoljem (ISO 12894:2001)

General Information

Status
Published
Publication Date
14-Jun-2001
Current Stage
9093 - Decision to confirm - Review Enquiry
Due Date
30-Sep-2006
Completion Date
30-Sep-2006

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SLOVENSKI STANDARD
SIST EN ISO 12894:2003
01-februar-2003
(UJRQRPLMDWRSORWQHJDRNROMD=GUDYVWYHQLQDG]RURVHENLVRL]SRVWDYOMHQH
L]MHPQRYURþLPDOLKODGQLPRNROMHP ,62

Ergonomics of the thermal environment - Medical supervision of individuals exposed to

extreme hot or cold environments (ISO 12894:2001)
Ergonomie des Umgebungsklimas - Medizinische Überwachung von Personen, die einer
extrem heißen oder kalten Umgebung ausgesetzt sind (ISO 12894:2001)

Ergonomie des ambiances thermiques - Surveillance médicale des personnes exposées

a la chaleur ou au froid extremes (ISO 12894:2001)
Ta slovenski standard je istoveten z: EN ISO 12894:2001
ICS:
13.100 Varnost pri delu. Industrijska Occupational safety.
higiena Industrial hygiene
13.180 Ergonomija Ergonomics
SIST EN ISO 12894:2003 en

2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.

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SIST EN ISO 12894:2003
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SIST EN ISO 12894:2003
EUROPEAN STANDARD
EN ISO 12894
NORME EUROPÉENNE
EUROPÄISCHE NORM
June 2001
ICS 13.100; 13.180
English version
Ergonomics of the thermal environment - Medical supervision of
individuals exposed to extreme hot or cold environments (ISO
12894:2001)

Ergonomie des ambiances thermiques - Surveillance Ergonomie des Umgebungsklimas - Medizinische

médicale des personnes exposées à la chaleur ou au froid Überwachung von Personen, die einer extrem heißen oder

extrêmes (ISO 12894:2001) kalten Umgebung ausgesetzt sind (ISO 12894:2001)
This European Standard was approved by CEN on 15 June 2001.

CEN members are bound to comply with the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this European

Standard the status of a national standard without any alteration. Up-to-date lists and bibliographical references concerning such national

standards may be obtained on application to the Management Centre or to any CEN member.

This European Standard exists in three official versions (English, French, German). A version in any other language made by translation

under the responsibility of a CEN member into its own language and notified to the Management Centre has the same status as the official

versions.

CEN members are the national standards bodies of Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Greece,

Iceland, Ireland, Italy, Luxembourg, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland and United Kingdom.

EUROPEAN COMMITTEE FOR STANDARDIZATION
COMITÉ EUROPÉEN DE NORMALISATION
EUROPÄISCHES KOMITEE FÜR NORMUNG
Management Centre: rue de Stassart, 36 B-1050 Brussels

© 2001 CEN All rights of exploitation in any form and by any means reserved Ref. No. EN ISO 12894:2001 E

worldwide for CEN national Members.
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SIST EN ISO 12894:2003
EN ISO 12894:2001 (E)
CORRECTED 2001-11-07
Foreword

The text of the International Standard from Technical Committee ISO/TC 159 "Ergonomics" of

the International Organization for Standardization (ISO) has been taken over as an European

Standard by Technical Committee CEN/TC 122 "Ergonomics", the secretariat of which is held

by DIN.

This European Standard shall be given the status of a national standard, either by publication

of an identical text or by endorsement, at the latest by December 2001, and conflicting

national standards shall be withdrawn at the latest by December 2001.

According to the CEN/CENELEC Internal Regulations, the national standards organizations of

the following countries are bound to implement this European Standard: Austria, Belgium,

Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy,

Luxembourg, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland and the United

Kingdom.
Endorsement notice

The text of the International Standard ISO 12894:2001 was approved by CEN as a European

Standard without any modification.
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SIST EN ISO 12894:2003
INTERNATIONAL ISO
STANDARD 12894
First edition
2001-06-15
Ergonomics of the thermal environment —
Medical supervision of individuals exposed
to extreme hot or cold environments
Ergonomie des ambiances thermiques — Surveillance médicale des
personnes exposées à la chaleur ou au froid extrêmes
Reference number
ISO 12894:2001(E)
ISO 2001
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SIST EN ISO 12894:2003
ISO 12894:2001(E)
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ii © ISO 2001 – All rights reserved
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SIST EN ISO 12894:2003
ISO 12894:2001(E)
Contents Page

Foreword.....................................................................................................................................................................iv

Introduction.................................................................................................................................................................v

1 Scope ..............................................................................................................................................................1

2 Normative references ....................................................................................................................................1

3 Terms and definitions ...................................................................................................................................2

4 Principles of medical supervision of individuals .......................................................................................2

4.1 General............................................................................................................................................................2

4.2 Ergonomic investigations.............................................................................................................................3

4.3 Occupational exposure .................................................................................................................................5

Annex A (informative) General principles underlying ergonomic investigations in which volunteer

subjects may experience discomfort ..........................................................................................................6

Annex B (informative) Medical effects of exposure to hot and cold......................................................................9

Annex C (informative) Medical supervision of individuals exposed to extreme hot environments in the

laboratory .....................................................................................................................................................13

Annex D (informative) Medical supervision of individuals exposed to cold environments in the

laboratory .....................................................................................................................................................18

Annex E (informative) Practical requirements of medical supervision in the laboratory, or during field

studies with volunteers not normally exposed ........................................................................................23

Annex F (informative) Occupational exposures to extreme heat and cold.........................................................25

Bibliography..............................................................................................................................................................29

© ISO 2001 – All rights reserved iii
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SIST EN ISO 12894:2003
ISO 12894:2001(E)
Foreword

ISO (the International Organization for Standardization) is a worldwide federation of national standards bodies (ISO

member bodies). The work of preparing International Standards is normally carried out through ISO technical

committees. Each member body interested in a subject for which a technical committee has been established has

the right to be represented on that committee. International organizations, governmental and non-governmental, in

liaison with ISO, also take part in the work. ISO collaborates closely with the International Electrotechnical

Commission (IEC) on all matters of electrotechnical standardization.

International Standards are drafted in accordance with the rules given in the ISO/IEC Directives, Part 3.

Draft International Standards adopted by the technical committees are circulated to the member bodies for voting.

Publication as an International Standard requires approval by at least 75 % of the member bodies casting a vote.

Attention is drawn to the possibility that some of the elements of this International Standard may be the subject of

patent rights. ISO shall not be held responsible for identifying any or all such patent rights.

International Standard ISO 12894 was prepared by Technical Committee ISO/TC 159, Ergomomics, Subcommittee

SC 5, Ergonomics of the physical environment.
Annexes A to F of this International Standard are for information only.
iv © ISO 2001 – All rights reserved
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SIST EN ISO 12894:2003
ISO 12894:2001(E)
Introduction

This International Standard is one of a group of standards which specify methods for measuring and evaluating hot,

moderate and cold thermal environments. International Standards or Technical Reports, which describe the

evaluation of hot and cold thermal environments, give advice on the acceptability of these environments for human

exposure, taking account of the activity level and the effects of clothing worn. That advice is given on the basis that

the individuals concerned are healthy, that is, without any medical factor which might predispose them to ill effects

from the thermal environment. Furthermore, biological variability prevents the accurate prediction of the response

of any particular individual to climatic extremes. For these reasons, it is necessary to provide appropriate medical

supervision for individuals who are to be exposed to extreme thermal environments. This International Standard

describes a method to determine the degree of medical supervision relevant to different types of exposure, in order

to limit the risk of any individual suffering from ill health.
© ISO 2001 – All rights reserved v
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SIST EN ISO 12894:2003
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SIST EN ISO 12894:2003
INTERNATIONAL STANDARD ISO 12894:2001(E)
Ergonomics of the thermal environment — Medical supervision of
individuals exposed to extreme hot or cold environments
1 Scope

This International Standard provides advice to those concerned with the safety of human exposures to extreme hot

or cold thermal environments. Extreme thermal environments are those which result in a high rate of heat gain or

loss by the body. A precise definition of such environments cannot easily be given, as the change in body heat

storage depends on clothing and activity as well as the parameters of the climatic environment. As a guide, the

boundaries of extreme environments might be considered to be as follows: for hot environments, a wet bulb globe

temperature of 25 °C; for cold environments an air temperature of 0 °C or below.

Extreme environments can only be tolerated for limited periods of time before a risk of ill health results. Control

measures are necessary to ensure the safety of those so exposed, one of which is the provision of appropriate

medical supervision prior to and during exposures.

This International Standard is intended to assist those with responsibility for such exposures to reach decisions

about the appropriate level of medical supervision in different situations. This International Standard should be read

and used in the context of other relevant guidance and legislation.

This guidance is applicable to laboratory and occupational exposures to extreme environments. In either case an

assessment should be made of the expected thermal stress on the individual, but the detailed arrangements for

medical supervision will differ. Control of occupational exposures must also satisfy national health and safety

legislation.

The laboratory or climatic chamber studies for which this International Standard will be relevant include those in

which people may be exposed to high or low ambient conditions or local heating or cooling. Studies may, for

example, investigate physiological or psychophysical responses to the environment or the benefit of clothing or

other protective equipment. Scientific investigations and demonstrations for teaching purposes are included in the

scope. In some countries, such studies are subject to specific legislation and, in all cases, experimental exposures

should be conducted in the context of accepted ethical criteria as detailed in relevant national and international

statements (see informative annex A and the bibliography).

Extremes of environment may be only one component of the total physiological stress imposed in a study. In such

cases, appropriate advice must also be obtained with regard to any medical supervision required prior to exposure

to the other stressors involved, for example whole body vibration.

In some cases, ergonomic investigations are conducted in the field, for example, to document the physiological

stress of particular occupations. If the overall stress of the task is increased as a result of the proposed study, this

International Standard will be relevant.

This International Standard does not apply to the use of hypo or hyper thermia in the course of medical

investigation or treatment.
2 Normative references

The following normative documents contain provisions which, through reference in this text, constitute provisions of

this International Standard. For dated references, subsequent amendments to, or revisions of, any of these

publications do not apply. However, parties to agreements based on this International Standard are encouraged to

© ISO 2001 – All rights reserved 1
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SIST EN ISO 12894:2003
ISO 12894:2001(E)

investigate the possibility of applying the most recent editions of the normative documents indicated below. For

undated references, the latest edition of the normative document referred to applies. Members of ISO and IEC

maintain registers of currently valid International Standards.
ISO 9886, Evaluation of thermal strain by physiological measurements.
ISO 13731, Ergonomics of the thermal environment — Vocabulary and symbols.
3 Terms and definitions

For the purposes of this International Standard, the following terms and definitions apply.

3.1
independent medical officer

qualified medical practitioner identified in a study protocol as responsible for the arrangements for medical fitness

assessment and health monitoring in support of a study to which this International Standard applies and who is not

the principal investigator
3.2
experimenter

the member of the investigation team who is in overall control of a particular experimental session

3.3
medical fitness assessment

procedure by which the state of past and present health of an individual is reviewed to identify any possible medical

predisposition to harm from exposure to extreme thermal environments
3.4
health monitoring

process in which the acute effects on the individual resulting from exposure to an extreme thermal environment are

observed and interpreted by someone with appropriate training, utilizing physiological monitoring and clinical

observation

NOTE The purpose is to detect any indications that an individual may no longer be adequately tolerating the exposure

conditions, and therefore to prevent any serious ill health arising, if necessary by removal of the individual from the exposure.

3.5
occupational physician

qualified medical practitioner who has received appropriate training and who is responsible for the supervision of

the health at work of employees in one or more enterprise
3.6
principal investigator

where more than one person is responsible for the design of a study a principal investigator should be nominated

and he or she will normally be responsible for obtaining ethical approval for a study and for ensuring that adequate

arrangements are made for medical supervision of the experimental subjects

NOTE In the case of multicentre studies with a centrally agreed protocol, the person organizing the study, i.e. the promoter,

may be responsible for seeking ethical approval.
4 Principles of medical supervision of individuals
4.1 General

The use of the relevant International Standards, given in clause 2, for the assessment of the thermal environment,

will allow exposures to be controlled in such a way that the risk of illness arising is minimized. Where body core

temperature is maintained in the band 36,0 °Cto 38,0 °C then serious general health effects, resulting from

2 © ISO 2001 – All rights reserved
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SIST EN ISO 12894:2003
ISO 12894:2001(E)

changes in body heat storage, are unlikely, although not entirely unknown. Core temperature is defined in

ISO 13731 and described in ISO 9886. In this International Standard, where reference is made to values of core

temperature, it is intended that these will have been obtained from valid measurement sites, such as those

described in ISO 9886.

If core temperature departs from the range previously specified, there is a progressively increasing risk of acute ill

health, specifically heat stroke (heat hyperpyrexia) or profound hypothermia, either of which can be life threatening.

Disorders resulting from changes in body heat storage are not, however, the only types of ill health that can arise in

extreme thermal environments. For example, in the cold, asthmatic attacks may occur, (particularly in association

with exercise), angina may be precipitated, and rhinitis, coughs and nose bleeds have all been reported. Also

peripheral cooling can result in frostbite. In the heat, blood flow redistribution can result in episodes of low blood

pressure and the risk of collapse before significant heat gain has occurred.

The main illnesses which can arise from changes in body heat storage in hot or cold environments are summarized

in informative annex B. This also gives information on the other health effects which can occur in hot and cold

conditions.

ISO 9886 and ISO 13731 apply only to healthy subjects in whom the normal physiological control of body

temperature is unimpaired. Also, they are unable to take account of the variability of responses between different

individuals, although some large differences, such as those between acclimatized and unaclimatized individuals,

are considered. For these reasons, it will be important, in the circumstances described below, to include a system

of medical supervision of the exposed individuals in risk management. Such supervision may entail both medical

fitness assessment prior to exposure and health monitoring during exposure.
4.2 Ergonomic investigations
4.2.1 Introduction

Ergonomic investigations may be conducted in the laboratory or in the field. In either case, the protection of the

individuals participating in the studies must be a major consideration.
4.2.2 Laboratory studies
4.2.2.1 General

Studies should be conducted according to accepted ethical guidelines, for example, as contained in the “Helsinki

Declaration” (see [8] in the bibliography). The study protocol should be approved by a local research ethics

committee. The Principal Investigator and each Experimenter should be aware of their duties towards the subjects

both in the design and conduct of the investigations. They should ensure that only individuals who have given their

consent participate in the studies and that subjects are free to withdraw from participation during the course of an

investigation if they so wish. The application of these principles is described in annex A.

The protocol should describe any arrangements for medical fitness assessment or health monitoring and identify an

independent medical officer responsible for the implementation of these arrangements. The medical officer may

advise on any likely risks to the subjects and on the level of fitness assessment and monitoring appropriate to the

intended study. The medical officer may delegate specific duties to appropriately qualified individuals, for example,

health monitoring during exposures may best be done by experienced laboratory staff with appropriate training in

first aid and basic resuscitation techniques. The medical officer will act as the final arbiter in questions of fitness of

particular individuals to participate in a study.

The medical officer should have practical experience of observing the effects of thermal stress on people, as well

as a sound theoretical knowledge of these effects. This may be obtained by cooperation with a research team, or in

the course of formal training in applied physiology or related disciplines.
4.2.2.2 Medical fitness assessment

Medical fitness assessment should take place prior to exposure to extreme hot or cold environments. This should

take account of the intended exposure conditions and is centred on the individual. It is intended to determine

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SIST EN ISO 12894:2003
ISO 12894:2001(E)

whether there are any reasons to consider that the person may be susceptible to ill effects from the planned

environmental exposure.

Assessment may be by questionnaire and medical examination and advice is given in informative annexes C and D

on when these options may be appropriate. If physiological measurement is to be used during exposure, either to

support health monitoring or to collect information, then simple initial health checks may also be required, see

informative annex E.

A questionnaire should always be completed and the option for a medical examination should be followed in every

case where there is any doubt about the fitness of an individual. Examination allows an assessment of the

psychological suitability of an individual which cannot be judged from responses to a questionnaire.

Where assessment is by questionnaire and this does not reveal any medical factor which may predispose an

individual to ill effects, he or she may be accepted as a subject. Where results suggest a possible predisposition,

an individual should only be accepted on the advice of a medical officer who may ask to examine the individual or

to obtain an opinion from a relevant specialist.
4.2.2.3 Health monitoring

Assessment of the anticipated physiological strain, coupled with appropriate medical fitness assessment will, in

most situations, provide adequate safeguards against the risk of illness occurring from exposure to hot or cold

conditions. In the more extreme conditions, to which this International Standard applies, and particularly in

exposures to heat, the onset of ill health and the occurrence of symptoms may be rapid and some form of health

monitoring is likely to be required to detect these changes and allow an early intervention. An example might be

where the prediction of physiological strain is not practicable due to the type of clothing to be worn.

The level of health monitoring required will depend on the detailed circumstances of exposure. The minimum

possible is the observation of the subjects by someone with experience of the effects of heat or cold on the body. In

many cases, the measurement of physiological parameters will form part of the experimental protocol and the data

collected will be used in the results of the study. If not already required for this reason, monitoring of core and skin

temperatures, heart rate and, in some cases, blood pressure is likely to be required as these factors may be

limiting. Upper limits for withdrawal of subjects from exposure should be decided as part of the experimental

protocol.

In most cases, it will be adequate for the monitoring to be done by a trained non-medical person and to have

access to the opinion of a medical officer but, in more severe conditions, it will be prudent for the medical officer, or

another appropriately trained person (such as an emergency medical technician or paramedic), to be available to

attend promptly to a casualty if required. Whether or not a medical officer is available to assist in monitoring and

treatment, it will be necessary to have arrangements in place for the rapid removal of a casualty to a hospital with

emergency facilities. More detailed advice on the appropriate level of monitoring is given in informative annexes C

and D.

During any prolonged series of experiments in which behavioural changes could occur in the subjects, there should

be arrangements in place to allow the experimenter and the independent medical officer to obtain the advice of a

psychologist.
4.2.3 Field investigations

Ergonomic investigations made in the field should conform to the same ethical guidelines provided for laboratory-

based studies. Where volunteers who are not normally employed in the work task act as subjects, the requirements

for medical fitness assessment and health monitoring are as described in 4.2.2.2 and 4.2.2.3.

Where workers regularly employed in the task under investigation are the subject of study, the requirements for

medical supervision should be agreed with the occupational physician responsible for the health of the workers.

The requirements will be based on those described in 4.3, taking account of the effect of the study on normal work

practices and of the views of workers and their representatives.
4 © ISO 2001 – All rights reserved
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SIST EN ISO 12894:2003
ISO 12894:2001(E)
4.2.4 Practical implementation of medical supervision

Advice on the practical requirements of medical supervision in the laboratory, or during field studies with volunteers

not normally exposed to the conditions, can be found in informative annex E.
4.3 Occupational exposure
4.3.1 General

Medical supervision of workers who may be exposed to very hot or cold conditions at work should form part of their

normal occupational health care and should take account of national health and safety legislation. Work

environments are generally less predictable than those used in laboratory investigations and some jobs may

require high rates of energy expenditure and the use of protective clothing. In these circumstances, endogenous

heat production contributes significantly to the resulting heat strain.

A risk assessment should be undertaken for all occupational exposures to extreme thermal environments. This

should allow an evaluation of the likely physiological strain of the task to be made, before the work actually begins.

Also, it should allow the available means of reducing this physiological strain to be identified. Work tasks should not

be designed in a way which permits unacceptable physiological strain to occur, for example, no work should be

planned in which the risk assessment shows that there is a significant potential for general hypothermia to occur.

However, where outdoor work takes place, it will not always be possible to entirely eliminate such risks, for

example, during fishing, forestry or agriculture in cold temperate or sub-arctic climates, or during construction work

in tropical latitudes.

Work which carries a risk of heat strain must be carefully controlled. Heat strain may however be expected to occur

in some emergency situations, such as rescue work in mines. The level of fitness assessment and health

monitoring should be matched to the circumstances of exposure and general guidance is given in annex F.

4.3.2 Medical fitness assessment

This will be determined by the occupational physician responsible for the workforce in the context of relevant

national legislation and guidance. All the components of the job should be taken into account and this may include

the need to respond to emergency situations. Direct health monitoring will often be impractical in work tasks,

therefore adequate fitness assessment with proper control of exposure will form the basis for the prevention of ill

health from exposure to heat or cold at work.
4.3.3 Health monitoring

After appropriate medical fitness assessments have been completed, health monitoring may still be required in

some occupational situations where expos
...

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